Provider Demographics
NPI:1366556078
Name:KRELL, WILLIAM L JR (DDS)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:L
Last Name:KRELL
Suffix:JR
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 1:3100 WESLAYAN ST
Mailing Address - Street 2:SUITE 222
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-5727
Mailing Address - Country:US
Mailing Address - Phone:713-621-1919
Mailing Address - Fax:713-621-3733
Practice Address - Street 1:3100 WESLAYAN ST
Practice Address - Street 2:SUITE 222
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-5727
Practice Address - Country:US
Practice Address - Phone:713-621-1919
Practice Address - Fax:713-621-3733
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX110991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice