Provider Demographics
NPI:1891961983
Name:MCCLURE, WILLIAM C (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:C
Last Name:MCCLURE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:WILLIAM
Other - Middle Name:C
Other - Last Name:MCCLURE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:601 NW 3RD ST
Mailing Address - Street 2:
Mailing Address - City:PRINEVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97754-1717
Mailing Address - Country:US
Mailing Address - Phone:541-447-4888
Mailing Address - Fax:
Practice Address - Street 1:601 NW 3RD ST
Practice Address - Street 2:
Practice Address - City:PRINEVILLE
Practice Address - State:OR
Practice Address - Zip Code:97754-1717
Practice Address - Country:US
Practice Address - Phone:541-447-4888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-07
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD5440122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist