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General NPI Number Information
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NPI Number | 1598802373
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Entity Type | Organization
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Legal Business Name | WILLIAM G BYRNE DDS MS
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3838 SHERMAN DR STE 8
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City | RIVERSIDE
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State | CA
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Zip | 92503
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Country | US
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Telephone | 951-687-6040
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Fax | 951-687-4216
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Provider Business Mailing Address
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Address Line | 3838 SHERMAN DR STE 8
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City | RIVERSIDE
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State | CA
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Zip | 92503
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Country | US
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Telephone | 951-687-6040
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Fax | 951-687-4216
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Authorized Official
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Title or Position | RECEPTIONIST - INS BILLER
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Name | MRS. ANITA LOUISE BACON
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Credential |
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Telephone | 951-687-6040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 21975
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License Number State | CA
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