Provider Demographics
NPI:1366428799
Name:FOSTER, WILLIAM LANG III (DMD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:LANG
Last Name:FOSTER
Suffix:III
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1109 ELLA STREET
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621
Mailing Address - Country:US
Mailing Address - Phone:864-261-8985
Mailing Address - Fax:864-261-8987
Practice Address - Street 1:1109 ELLA STREET
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621
Practice Address - Country:US
Practice Address - Phone:864-261-8985
Practice Address - Fax:864-261-8987
Is Sole Proprietor?:No
Enumeration Date:2005-12-18
Last Update Date:2014-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC003318122300000X, 1223X0400X
GA0136541223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No122300000XDental ProvidersDentist