Provider Demographics
NPI:1124127626
Name:GROSS, WILLIAM BERNARD (DDS)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:BERNARD
Last Name:GROSS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10970 CHAPEL HILL ROAD
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-2801
Mailing Address - Country:US
Mailing Address - Phone:201-404-1798
Mailing Address - Fax:
Practice Address - Street 1:10970 CHAPEL HILL ROAD
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560-2801
Practice Address - Country:US
Practice Address - Phone:201-404-1798
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10539332B00000X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies