Healthcare Provider Details

I. General information

NPI: 1588702799
Provider Name (Legal Business Name): WILLIAM J. VERAX III, DMD, PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2007
Last Update Date: 08/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 W SHELBY STREET
FALMOUTH KY
41040
US

IV. Provider business mailing address

211 W SHELBY STREET
FALMOUTH KY
41040
US

V. Phone/Fax

Practice location:
  • Phone: 859-654-5041
  • Fax: 859-654-4186
Mailing address:
  • Phone: 859-654-5041
  • Fax: 859-654-4186

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberPLEASE CALL TO VERIF
License Number StateKY

VIII. Authorized Official

Name: DR. WILLIAM JOSEPH VERAX III
Title or Position: PRESIDENT OWNER
Credential: DMD
Phone: 859-654-5041