Provider Demographics
NPI:1659600872
Name:RADFORD, WILLIAM HUBERT JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:HUBERT
Last Name:RADFORD
Suffix:JR
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 1:196 LAURELWOOD RD
Mailing Address - Street 2:
Mailing Address - City:STATE ROAD
Mailing Address - State:NC
Mailing Address - Zip Code:28676-9148
Mailing Address - Country:US
Mailing Address - Phone:919-210-7769
Mailing Address - Fax:
Practice Address - Street 1:1550 N BRIDGE ST
Practice Address - Street 2:
Practice Address - City:ELKIN
Practice Address - State:NC
Practice Address - Zip Code:28621-2202
Practice Address - Country:US
Practice Address - Phone:919-210-7769
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-17
Last Update Date:2016-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8888122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist