Provider Demographics
NPI:1568557908
Name:WIGGANS, WILLIAM HAROLD (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:HAROLD
Last Name:WIGGANS
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 1:240 WEST 4TH AVENUE
Mailing Address - Street 2:
Mailing Address - City:GARNETT
Mailing Address - State:KS
Mailing Address - Zip Code:66032
Mailing Address - Country:US
Mailing Address - Phone:785-448-3422
Mailing Address - Fax:785-448-3070
Practice Address - Street 1:240 WEST 4TH AVENUE
Practice Address - Street 2:
Practice Address - City:GARNETT
Practice Address - State:KS
Practice Address - Zip Code:66032
Practice Address - Country:US
Practice Address - Phone:785-448-3422
Practice Address - Fax:785-448-3070
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS47291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice