MEDICARE: DR. WILLIAM BRUCE SHERRILL D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	12904	TX

General Provider Information

NPI Number	:	1043212046
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM BRUCE SHERRILL D.D.S.

Provider Business Mailing Address
First Line	:	10670 N CENTRAL EXPY
Second Line	:	STE 525
City	:	DALLAS
State	:	TX
Zip	:	75231-2111
Country	:	US
Telephone Number	:	214-341-9306
Fax Number	:	214-341-3262

Provider Business Practice Location Address
First Line	:	10670 N CENTRAL EXPY
Second Line	:	STE 525
City	:	DALLAS
State	:	TX
Zip	:	75231-2111
Country	:	US
Telephone Number	:	214-341-9306
Fax Number	:	214-341-3262

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	07/08/2007

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