Provider Demographics
NPI:1538244595
Name:QUEENSGATE DENTAL
Entity type:Organization
Organization Name:QUEENSGATE DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:H
Authorized Official - Last Name:CLOYD
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:717-843-8011
Mailing Address - Street 1:2087 SPRINGWOOD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-4827
Mailing Address - Country:US
Mailing Address - Phone:717-843-8011
Mailing Address - Fax:717-843-4414
Practice Address - Street 1:2081 SPRINGWOOD RD
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403
Practice Address - Country:US
Practice Address - Phone:717-843-8011
Practice Address - Fax:717-843-4414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2014-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS024963L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty