Provider Demographics
NPI:1174621502
Name:BARRETT, WILLIAM K III (DDS)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:K
Last Name:BARRETT
Suffix:III
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 1:6500 STAGE ROAD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38134-2882
Mailing Address - Country:US
Mailing Address - Phone:901-388-0980
Mailing Address - Fax:901-385-6345
Practice Address - Street 1:6500 STAGE ROAD
Practice Address - Street 2:SUITE 1
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38134-2882
Practice Address - Country:US
Practice Address - Phone:901-388-0980
Practice Address - Fax:901-385-6345
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS26631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice