Provider Demographics
NPI:1457454084
Name:PASCO, WILLIAM NALL (DMD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:NALL
Last Name:PASCO
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 1:1653 CALLOWAY AVE
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:KY
Mailing Address - Zip Code:42071
Mailing Address - Country:US
Mailing Address - Phone:270-753-1914
Mailing Address - Fax:270-753-5923
Practice Address - Street 1:1653 CALLOWAY AVE
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:KY
Practice Address - Zip Code:42071
Practice Address - Country:US
Practice Address - Phone:270-753-1914
Practice Address - Fax:270-753-5923
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY5341122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY60053410Medicaid