Provider Demographics
NPI:1124069265
Name:HARRIETT, WILLIAM E (DMD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:E
Last Name:HARRIETT
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 1:4707 NW 71ST PL
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32653-1155
Mailing Address - Country:US
Mailing Address - Phone:352-335-3786
Mailing Address - Fax:352-335-5180
Practice Address - Street 1:1230 NW 9TH AVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32601-4942
Practice Address - Country:US
Practice Address - Phone:352-376-3942
Practice Address - Fax:352-376-8281
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN00110881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice