Provider Demographics
NPI:1548254469
Name:CREGAR, WILLIAM R (DDS)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:R
Last Name:CREGAR
Suffix:
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 1:438 GANTTOWN RD
Mailing Address - Street 2:SUITE B-2
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-2341
Mailing Address - Country:US
Mailing Address - Phone:856-589-4300
Mailing Address - Fax:856-218-0051
Practice Address - Street 1:438 GANTTOWN RD
Practice Address - Street 2:SUITE B-2
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-2341
Practice Address - Country:US
Practice Address - Phone:856-589-4300
Practice Address - Fax:856-218-0051
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI013402001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice