MEDICARE: DR. WILLIAM CLYDE WINDLEY III DDS, MS

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	1223E0200X	Endodontics	7340	NC

General Provider Information

NPI Number	:	1326108135
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM CLYDE WINDLEY III DDS, MS

Provider Business Mailing Address
First Line	:	140 PRESTON EXECUTIVE DR
Second Line	:	SUITE 201
City	:	CARY
State	:	NC
Zip	:	27513-8488
Country	:	US
Telephone Number	:	919-468-1435
Fax Number	:	919-468-7250

Provider Business Practice Location Address
First Line	:	140 PRESTON EXECUTIVE DR
Second Line	:	SUITE 201
City	:	CARY
State	:	NC
Zip	:	27513-8488
Country	:	US
Telephone Number	:	919-468-1435
Fax Number	:	919-468-7250

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

Provider Enumeration Date	:	12/11/2006
Last Update Date	:	07/08/2007

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