Provider Demographics
NPI:1487682142
Name:HARRISON, WILLIAM HUDSON (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:HUDSON
Last Name:HARRISON
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:PO BOX 506
Mailing Address - Street 2:
Mailing Address - City:MILAN
Mailing Address - State:TN
Mailing Address - Zip Code:38358-0506
Mailing Address - Country:US
Mailing Address - Phone:731-686-3956
Mailing Address - Fax:731-723-4067
Practice Address - Street 1:4129 S 1ST ST
Practice Address - Street 2:
Practice Address - City:MILAN
Practice Address - State:TN
Practice Address - Zip Code:38358
Practice Address - Country:US
Practice Address - Phone:731-686-3956
Practice Address - Fax:731-723-4067
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS3719122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist