Provider Demographics
NPI:1881329191
Name:SHALLER, WILLIAM (DMD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:SHALLER
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 1:7001 ARLINGTON RD APT 206
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-5486
Mailing Address - Country:US
Mailing Address - Phone:828-421-4828
Mailing Address - Fax:
Practice Address - Street 1:8930 BROWN DRIVE HOSPITAL DENTISTRY BLD 9, 2ND FLOOR
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-0001
Practice Address - Country:US
Practice Address - Phone:828-421-4828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-20
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN27355122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist