Healthcare Provider Details

I. General information

NPI: 1932039112
Provider Name (Legal Business Name): WILLIAM WOOD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 N SALEM ST STE 104
APEX NC
27523-8398
US

IV. Provider business mailing address

1800 N SALEM ST STE 104
APEX NC
27523-8398
US

V. Phone/Fax

Practice location:
  • Phone: 855-550-0707
  • Fax:
Mailing address:
  • Phone: 855-550-0707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code126900000X
TaxonomyDental Laboratory Technician
License Number235804-00
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: