Provider Demographics
NPI:1508826934
Name:SPADES, WILLIAMS A (DDS)
Entity Type:Individual
Prefix:
First Name:WILLIAMS
Middle Name:A
Last Name:SPADES
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 1:900 SOUTHWEST DR
Mailing Address - Street 2:SUITE D
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-7051
Mailing Address - Country:US
Mailing Address - Phone:870-910-0000
Mailing Address - Fax:870-910-3500
Practice Address - Street 1:900 SOUTHWEST DR
Practice Address - Street 2:SUITE D
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-7051
Practice Address - Country:US
Practice Address - Phone:870-910-0000
Practice Address - Fax:870-910-3500
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR32991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice