Provider Demographics
NPI:1275697500
Name:BILL PICKARD, D.D.S., M.S., P.A.
Entity Type:Organization
Organization Name:BILL PICKARD, D.D.S., M.S., P.A.
Other - Org Name:ARKANSAS ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BILL
Authorized Official - Middle Name:
Authorized Official - Last Name:PICKARD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS, PA
Authorized Official - Phone:479-782-7080
Mailing Address - Street 1:4400 ROGERS AVE STE C
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72903-3179
Mailing Address - Country:US
Mailing Address - Phone:479-782-7080
Mailing Address - Fax:479-782-7072
Practice Address - Street 1:4400 ROGERS AVE STE C
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-3179
Practice Address - Country:US
Practice Address - Phone:479-782-7080
Practice Address - Fax:479-782-7072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR20351223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5F642OtherBCBS
AR814087OtherUNITED CONCORDIA