Provider Demographics
NPI:1104924521
Name:FORERO, WILLIAM ALBERTO (DMD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ALBERTO
Last Name:FORERO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 UNIVERSITY DR
Mailing Address - Street 2:SUITE P
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065
Mailing Address - Country:US
Mailing Address - Phone:954-752-4900
Mailing Address - Fax:954-752-3490
Practice Address - Street 1:3000 UNIVERSITY DR
Practice Address - Street 2:SUITE P
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065
Practice Address - Country:US
Practice Address - Phone:954-752-4900
Practice Address - Fax:954-752-3490
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLD169651223G0001X
FLDN16965122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice