Provider Demographics
NPI:1831287507
Name:KO, WILLIAM Y (DDS)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:Y
Last Name:KO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2140 W ARLINGTON BLVD
Mailing Address - Street 2:STE E
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-5709
Mailing Address - Country:US
Mailing Address - Phone:252-355-5252
Mailing Address - Fax:252-355-7776
Practice Address - Street 1:2140 W ARLINGTON BLVD
Practice Address - Street 2:STE E
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-5709
Practice Address - Country:US
Practice Address - Phone:252-355-5252
Practice Address - Fax:252-355-7776
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7711122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist