Healthcare Provider Details

I. General information

NPI: 1457325409
Provider Name (Legal Business Name): WILLIAM CARY DUNSON DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195 GREENCASTLE RD
TYRONE GA
30290
US

IV. Provider business mailing address

195 GREENCASTLE RD
TYRONE GA
30290
US

V. Phone/Fax

Practice location:
  • Phone: 770-486-5585
  • Fax: 770-486-9877
Mailing address:
  • Phone: 770-486-5585
  • Fax: 770-486-9877

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number007862
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: