Provider Demographics
NPI:1184607053
Name:HARTMAN, WILLIAM E (DDS)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:E
Last Name:HARTMAN
Suffix:
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 1:5732 WIDMER RD
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66216-3868
Mailing Address - Country:US
Mailing Address - Phone:913-631-2709
Mailing Address - Fax:
Practice Address - Street 1:13031 KANSAS AVE
Practice Address - Street 2:
Practice Address - City:BONNER SPRINGS
Practice Address - State:KS
Practice Address - Zip Code:66012-9206
Practice Address - Country:US
Practice Address - Phone:913-441-1600
Practice Address - Fax:913-441-1628
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS62451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice