Provider Demographics
NPI:1881758191
Name:BEGALLA, WILLIAM SCOTT (DDS)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:SCOTT
Last Name:BEGALLA
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 1:7381 CALIFORNIA AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44572
Mailing Address - Country:US
Mailing Address - Phone:330-726-1668
Mailing Address - Fax:330-726-0885
Practice Address - Street 1:7381 CALIFORNIA AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44572
Practice Address - Country:US
Practice Address - Phone:330-726-1668
Practice Address - Fax:330-726-0885
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30017445122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0648857Medicaid