Provider Demographics
NPI:1851555635
Name:DONOVAN, WILLIAM COLLINS (DMD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:COLLINS
Last Name:DONOVAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 SAMS POINT RD
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29907-2010
Mailing Address - Country:US
Mailing Address - Phone:706-231-4092
Mailing Address - Fax:
Practice Address - Street 1:65 SAMS POINT RD
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29907-2010
Practice Address - Country:US
Practice Address - Phone:706-231-4092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-11
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0137391223G0001X
SCDGD 71111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice