Individual
DR. WILLIAM BAILEY PRUDEN III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
628 PROGRESS ST STE 200, WEST BRANCH, MI 48661-9383
(989) 343-1496
(989) 343-1498
Mailing address
3434 M 119, STE H, HARBOR SPRINGS, MI 49740-9373
(231) 251-9083
(231) 308-5941
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901020828
MI
1223G0001X
General Practice Dentistry
0401008656
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7708
—
VA
Enumeration date
04/02/2007
Last updated
12/08/2021
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