MEDICARE: WILLIAM G DOLS 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
1	122300000X	Dentist	D5011	MN

General Provider Information

NPI Number	:	1447240163
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM G DOLS DDS

Provider Business Mailing Address
First Line	:	4515 E SUPERIOR ST
Second Line	:
City	:	DULUTH
State	:	MN
Zip	:	55804-2337
Country	:	US
Telephone Number	:	218-525-6661
Fax Number	:

Provider Business Practice Location Address
First Line	:	4515 E SUPERIOR ST
Second Line	:
City	:	DULUTH
State	:	MN
Zip	:	55804-2337
Country	:	US
Telephone Number	:	218-525-6661
Fax Number	:

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

Provider Enumeration Date	:	10/25/2005
Last Update Date	:	01/11/2026

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