Provider Demographics
NPI:1134221203
Name:MULDOON, WILLIAM BERNARD JR (DDS)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:BERNARD
Last Name:MULDOON
Suffix:JR
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:PO BOX 464
Mailing Address - Street 2:74 COUNTY ROAD
Mailing Address - City:MATTAPOISETT
Mailing Address - State:MA
Mailing Address - Zip Code:02739-0464
Mailing Address - Country:US
Mailing Address - Phone:508-758-4925
Mailing Address - Fax:508-758-4313
Practice Address - Street 1:74 COUNTY ROAD
Practice Address - Street 2:
Practice Address - City:MATTAPOISETT
Practice Address - State:MA
Practice Address - Zip Code:02739-0464
Practice Address - Country:US
Practice Address - Phone:508-758-4925
Practice Address - Fax:508-758-4313
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA130661223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health