Provider Demographics
NPI:1780704858
Name:BEGEMAN, WILLIAM H (DDS)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:H
Last Name:BEGEMAN
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 1:118 S GREEN ST
Mailing Address - Street 2:
Mailing Address - City:GREENTOWN
Mailing Address - State:IN
Mailing Address - Zip Code:46936-1411
Mailing Address - Country:US
Mailing Address - Phone:765-628-7970
Mailing Address - Fax:765-628-0630
Practice Address - Street 1:118 S GREEN ST
Practice Address - Street 2:
Practice Address - City:GREENTOWN
Practice Address - State:IN
Practice Address - Zip Code:46936-1411
Practice Address - Country:US
Practice Address - Phone:765-628-7970
Practice Address - Fax:765-628-0630
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN64721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice