Provider Demographics
NPI:1730205121
Name:SENTIERE, WILLIAM JOHN (DDS,MSD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:JOHN
Last Name:SENTIERE
Suffix:
Gender:M
Credentials:DDS,MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3925 HAGAN ST
Mailing Address - Street 2:204
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47401-8556
Mailing Address - Country:US
Mailing Address - Phone:812-333-0358
Mailing Address - Fax:812-333-8386
Practice Address - Street 1:3925 HAGAN ST
Practice Address - Street 2:204
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47401-8556
Practice Address - Country:US
Practice Address - Phone:812-333-0358
Practice Address - Fax:812-333-8386
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN1200 89931223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics