Provider Demographics
NPI:1891967311
Name:WILLIAM E POOLE DDS PC
Entity Type:Organization
Organization Name:WILLIAM E POOLE DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:E
Authorized Official - Last Name:POOLE
Authorized Official - Suffix:III
Authorized Official - Credentials:DDS
Authorized Official - Phone:717-656-2586
Mailing Address - Street 1:PO BOX 160
Mailing Address - Street 2:21 EAST MAIN ST
Mailing Address - City:LEOLA
Mailing Address - State:PA
Mailing Address - Zip Code:17540
Mailing Address - Country:US
Mailing Address - Phone:717-656-2586
Mailing Address - Fax:717-656-9504
Practice Address - Street 1:21 EAST MAIN ST
Practice Address - Street 2:
Practice Address - City:LEOLA
Practice Address - State:PA
Practice Address - Zip Code:17540
Practice Address - Country:US
Practice Address - Phone:717-656-2586
Practice Address - Fax:717-656-9504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-25
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS035154122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty