Provider Demographics
NPI:1104012723
Name:DAGGETT, WILLIAM H (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:H
Last Name:DAGGETT
Suffix:
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 1:5745 N PASEO VENTOSO
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85750-1129
Mailing Address - Country:US
Mailing Address - Phone:520-299-9170
Mailing Address - Fax:
Practice Address - Street 1:4676 E 5TH ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-7006
Practice Address - Country:US
Practice Address - Phone:520-323-1462
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-18
Last Update Date:2010-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ68521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice