Provider Demographics
NPI:1326210303
Name:BUCK, WILLIAM HOLLINGSWORTH JR (DDS)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:HOLLINGSWORTH
Last Name:BUCK
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:PO BOX 321392
Mailing Address - Street 2:
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232-1392
Mailing Address - Country:US
Mailing Address - Phone:601-936-4242
Mailing Address - Fax:
Practice Address - Street 1:540 KEYWAY DR
Practice Address - Street 2:SUITE C
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-8208
Practice Address - Country:US
Practice Address - Phone:601-936-4242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-30
Last Update Date:2012-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1878-801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice