Healthcare Provider Details

I. General information

NPI: 1700968906
Provider Name (Legal Business Name): WILLIAM G WOODS DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2855 E BROWN RD STE #22
MESA AZ
85213
US

IV. Provider business mailing address

2855 E BROWN RD STE #22
MESA AZ
85213
US

V. Phone/Fax

Practice location:
  • Phone: 480-830-2956
  • Fax: 480-830-3019
Mailing address:
  • Phone: 480-830-2956
  • Fax: 480-830-3019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2316
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: