Provider Demographics
NPI:1457371601
Name:HOOLIHAN, WILLIAM LACROIX (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:LACROIX
Last Name:HOOLIHAN
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 1:78015 MAIN ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:LA QUINTA
Mailing Address - State:CA
Mailing Address - Zip Code:92253-3420
Mailing Address - Country:US
Mailing Address - Phone:760-564-7004
Mailing Address - Fax:760-564-7064
Practice Address - Street 1:78015 MAIN ST
Practice Address - Street 2:SUITE 203
Practice Address - City:LA QUINTA
Practice Address - State:CA
Practice Address - Zip Code:92253-3420
Practice Address - Country:US
Practice Address - Phone:760-564-7004
Practice Address - Fax:760-564-7064
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN513921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice