Provider Demographics
NPI:1770796377
Name:CLEVELAND, WILLIAM ALBERT (DMD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ALBERT
Last Name:CLEVELAND
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 E LANCASTER AVE
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:PA
Mailing Address - Zip Code:19087-4220
Mailing Address - Country:US
Mailing Address - Phone:610-688-4023
Mailing Address - Fax:610-688-2970
Practice Address - Street 1:427 E LANCASTER AVE
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:PA
Practice Address - Zip Code:19087-4220
Practice Address - Country:US
Practice Address - Phone:610-688-4023
Practice Address - Fax:610-688-2970
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADSO17152L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice