Provider Demographics
NPI:1346599032
Name:SEDWICK, WILLIAM RUTAN (DDS)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:RUTAN
Last Name:SEDWICK
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 1:3900 ARCTIC BLVD. .STE 103
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-5780
Mailing Address - Country:US
Mailing Address - Phone:907-563-7517
Mailing Address - Fax:907-561-8682
Practice Address - Street 1:3900 ARCTIC BLVD. STE 103
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-5780
Practice Address - Country:US
Practice Address - Phone:907-563-7517
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-10
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKNO.3831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice