Provider Demographics
NPI:1922193937
Name:FOOTE, WILLIAM EUGENE IV (DDS)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:EUGENE
Last Name:FOOTE
Suffix:IV
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 1:201 S CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:AR
Mailing Address - Zip Code:71646
Mailing Address - Country:US
Mailing Address - Phone:870-853-4486
Mailing Address - Fax:870-853-4486
Practice Address - Street 1:201 S CHERRY ST
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:AR
Practice Address - Zip Code:71646
Practice Address - Country:US
Practice Address - Phone:870-853-4486
Practice Address - Fax:870-853-4486
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR3255122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist