Provider Demographics
NPI:1740583665
Name:KELSON, WILLIAM E (DDS)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:E
Last Name:KELSON
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 1:801 WAYNE AVE
Mailing Address - Street 2:SUITE 401
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-4450
Mailing Address - Country:US
Mailing Address - Phone:240-247-0249
Mailing Address - Fax:301-589-0504
Practice Address - Street 1:801 WAYNE AVE
Practice Address - Street 2:SUITE 401
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-4450
Practice Address - Country:US
Practice Address - Phone:240-247-0249
Practice Address - Fax:301-589-0504
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-15
Last Update Date:2010-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD103941223G0001X
MDD314541223G0001X
DCDEN52771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice