Provider Demographics
NPI:1215963277
Name:RUNYON, WILLIAM FRANCIS JR (DDS)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:FRANCIS
Last Name:RUNYON
Suffix:JR
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 1:4300 OAK PARK LN
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76109-1512
Mailing Address - Country:US
Mailing Address - Phone:817-731-2789
Mailing Address - Fax:817-207-9980
Practice Address - Street 1:4300 OAK PARK LN
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76109-1512
Practice Address - Country:US
Practice Address - Phone:817-731-2789
Practice Address - Fax:817-207-9980
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX158231223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery