Provider Demographics
NPI:1922451517
Name:WILLIAM MCFATTER III DDS PC
Entity Type:Organization
Organization Name:WILLIAM MCFATTER III DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:MCFATTER
Authorized Official - Suffix:III
Authorized Official - Credentials:DDS
Authorized Official - Phone:229-377-6588
Mailing Address - Street 1:2515 US HIGHWAY 319 S
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31792-0439
Mailing Address - Country:US
Mailing Address - Phone:229-377-6588
Mailing Address - Fax:
Practice Address - Street 1:2515 US HIGHWAY 319 S
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:GA
Practice Address - Zip Code:31792-0439
Practice Address - Country:US
Practice Address - Phone:229-377-6588
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-19
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty