Provider Demographics
NPI:1164847232
Name:CLANCE, WILLIAM CHRISTOPHER (DMD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:CHRISTOPHER
Last Name:CLANCE
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 1:2068 WALTON WAY
Mailing Address - Street 2:APT. 302
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30904-4156
Mailing Address - Country:US
Mailing Address - Phone:912-690-1624
Mailing Address - Fax:
Practice Address - Street 1:2068 WALTON WAY
Practice Address - Street 2:APT. 302
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30904-4156
Practice Address - Country:US
Practice Address - Phone:912-690-1624
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-26
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0148691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice