Provider Demographics
NPI:1518110881
Name:BILL N BETHARDS DDS PS
Entity Type:Organization
Organization Name:BILL N BETHARDS DDS PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BILL
Authorized Official - Middle Name:N
Authorized Official - Last Name:BETHARDS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:360-293-4695
Mailing Address - Street 1:1019 24TH ST
Mailing Address - Street 2:
Mailing Address - City:ANACORTES
Mailing Address - State:WA
Mailing Address - Zip Code:98221-2586
Mailing Address - Country:US
Mailing Address - Phone:360-293-4695
Mailing Address - Fax:360-293-4813
Practice Address - Street 1:1019 24TH ST
Practice Address - Street 2:
Practice Address - City:ANACORTES
Practice Address - State:WA
Practice Address - Zip Code:98221-2586
Practice Address - Country:US
Practice Address - Phone:360-293-4695
Practice Address - Fax:360-293-4813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-30
Last Update Date:2008-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA4830261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental