Provider Demographics
NPI:1861706012
Name:FIORE, WILLIAM (DMD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:FIORE
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 1:1271 S LOLA LN
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-4838
Mailing Address - Country:US
Mailing Address - Phone:623-326-6837
Mailing Address - Fax:
Practice Address - Street 1:2246 JACKSBORO HWY STE 122
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76114-2363
Practice Address - Country:US
Practice Address - Phone:817-529-1799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-29
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25783122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist