Provider Demographics
NPI:1700955606
Name:SHOLD, WILLIAM G (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:G
Last Name:SHOLD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6050 BRYNWOOD DR
Mailing Address - Street 2:SUITE 205
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61114-6579
Mailing Address - Country:US
Mailing Address - Phone:815-877-7780
Mailing Address - Fax:815-877-7710
Practice Address - Street 1:6050 BRYNWOOD DR
Practice Address - Street 2:SUITE 205
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61114-6579
Practice Address - Country:US
Practice Address - Phone:815-877-7780
Practice Address - Fax:815-877-7710
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice