Healthcare Provider Details

I. General information

NPI: 1316004468
Provider Name (Legal Business Name): WILLIAM G. HARPER D.D.S., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/01/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 WYTHE CREEK RD
POQUOSON VA
23662-1911
US

IV. Provider business mailing address

235 WYTHE CREEK RD
POQUOSON VA
23662-1911
US

V. Phone/Fax

Practice location:
  • Phone: 757-868-8152
  • Fax:
Mailing address:
  • Phone: 757-868-8152
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number0401410272
License Number StateVA

VIII. Authorized Official

Name: DR. WILLIAM GEORGE HARPER
Title or Position: OWNER
Credential: D.D.S.
Phone: 757-868-8152