Provider Demographics
NPI:1952387540
Name:DENNIS, WILLIAM (DMD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:DENNIS
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 1:3 WOODSTOWN DR
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-9502
Mailing Address - Country:US
Mailing Address - Phone:774-840-0613
Mailing Address - Fax:
Practice Address - Street 1:351 PLEASANT LAKE AVE
Practice Address - Street 2:
Practice Address - City:HARWICH
Practice Address - State:MA
Practice Address - Zip Code:02645-1813
Practice Address - Country:US
Practice Address - Phone:508-430-7710
Practice Address - Fax:508-430-1599
Is Sole Proprietor?:No
Enumeration Date:2005-12-16
Last Update Date:2008-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA20521122300000X
NJ22DI012561122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist