Basic Information
| Provider Information | |||||||||
| NPI: | 1740217595 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DENTON | ||||||||
| FirstName: | WILLIAM | ||||||||
| MiddleName: | JAY | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | OD, FAAO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1512 OLDENBURG DR | ||||||||
| Address2: | |||||||||
| City: | MT PLEASANT | ||||||||
| State: | SC | ||||||||
| PostalCode: | 294294966 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8032367589 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 109 BEE ST | ||||||||
| Address2: | |||||||||
| City: | CHARLESTON | ||||||||
| State: | SC | ||||||||
| PostalCode: | 294015703 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8435775011 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/27/2006 | ||||||||
| LastUpdateDate: | 08/04/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/04/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152WC0802X | 1178 | SC | N | Eye and Vision Services Providers | Optometrist | Corneal and Contact Management | 152WL0500X | 1178 | SC | N | Eye and Vision Services Providers | Optometrist | Low Vision Rehabilitation | 152W00000X | 1178 | SC | Y | Eye and Vision Services Providers | Optometrist |
No ID Information.