Provider Demographics
NPI:1659673135
Name:WARD, NATHAN WILLIAM (DDS)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:WILLIAM
Last Name:WARD
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 1:930 SUNNYSLOPE RD STE D4
Mailing Address - Street 2:
Mailing Address - City:HOLLISTER
Mailing Address - State:CA
Mailing Address - Zip Code:95023-5638
Mailing Address - Country:US
Mailing Address - Phone:831-637-1675
Mailing Address - Fax:
Practice Address - Street 1:930 SUNNYSLOPE RD STE D4
Practice Address - Street 2:
Practice Address - City:HOLLISTER
Practice Address - State:CA
Practice Address - Zip Code:95023-5638
Practice Address - Country:US
Practice Address - Phone:831-637-1675
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-03
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA596151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice