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NPI Code Detail

MEDICARE: DR. WILLIAM G ANGELOS D.D.S.

MEDICARE: DR. WILLIAM G ANGELOS 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
11223G0001XGeneral Practice Dentistry9965FL

General Provider Information

NPI Number : 1659580868
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILLIAM G ANGELOS D.D.S.
Provider Business Mailing Address
First Line : 4846 N KINGS HWY
Second Line :
City : FORT PIERCE
State : FL
Zip : 34951-2243
Country : US
Telephone Number : 772-468-6226
Fax Number : 772-468-6226
Provider Business Practice Location Address
First Line : 4846 N KINGS HWY
Second Line :
City : FORT PIERCE
State : FL
Zip : 34951-2243
Country : US
Telephone Number : 772-468-6226
Fax Number : 772-468-6226
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2007
Last Update Date : 07/08/2007

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