Healthcare Provider Details

I. General information

NPI: 1811102965
Provider Name (Legal Business Name): DR. WILLIAM F DENNY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1252 IRVINE BLVD
TUSTIN CA
92780
US

IV. Provider business mailing address

1252 IRVINE BLVD
TUSTIN CA
92780
US

V. Phone/Fax

Practice location:
  • Phone: 714-832-9151
  • Fax: 714-832-9475
Mailing address:
  • Phone: 714-832-9151
  • Fax: 714-832-9475

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number20339
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: