Provider Demographics
NPI:1982817599
Name:WILLIAM J CARMODY DDS PC
Entity Type:Organization
Organization Name:WILLIAM J CARMODY DDS PC
Other - Org Name:ROCHESTER DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:CARMODY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:248-528-0700
Mailing Address - Street 1:4893 ROCHESTER RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48085-4971
Mailing Address - Country:US
Mailing Address - Phone:248-528-0700
Mailing Address - Fax:248-528-0607
Practice Address - Street 1:4893 ROCHESTER RD
Practice Address - Street 2:SUITE C
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48085-4971
Practice Address - Country:US
Practice Address - Phone:248-528-0700
Practice Address - Fax:248-528-0607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty