Provider Demographics
NPI:1114034402
Name:NASH, WILLIAM CARL (DMD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:CARL
Last Name:NASH
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 1:2157 MILL PLAIN RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-3030
Mailing Address - Country:US
Mailing Address - Phone:203-259-5328
Mailing Address - Fax:203-259-6488
Practice Address - Street 1:2157 MILL PLAIN RD
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-3030
Practice Address - Country:US
Practice Address - Phone:203-259-5328
Practice Address - Fax:203-259-6488
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT052221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice