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NPI Code Detail

MEDICARE: DR. WILLIAM NERESTANT DDS

MEDICARE:  DR. WILLIAM  NERESTANT  DDS
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
11223G0001XGeneral Practice DentistryDN 15580FL

General Provider Information

NPI Number : 1053468637
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILLIAM NERESTANT DDS
Provider Business Mailing Address
First Line : 607 S MISSOURI AVE
Second Line :
City : LAKELAND
State : FL
Zip : 33815-4735
Country : US
Telephone Number : 863-688-9001
Fax Number : 863-686-6732
Provider Business Practice Location Address
First Line : 607 S MISSOURI AVE
Second Line :
City : LAKELAND
State : FL
Zip : 33815-4735
Country : US
Telephone Number : 863-688-9001
Fax Number : 863-686-6732
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/04/2007
Last Update Date : 07/08/2007

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Directions to “ DR. WILLIAM NERESTANT DDS” Practice Location

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