Provider Demographics
NPI:1750468724
Name:LIGON, WILLIAM CLARK (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:CLARK
Last Name:LIGON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:BILL
Other - Middle Name:
Other - Last Name:LIGON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:8020 DALLAS ST
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72903-4277
Mailing Address - Country:US
Mailing Address - Phone:479-452-6600
Mailing Address - Fax:479-452-6692
Practice Address - Street 1:8020 DALLAS ST
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-4277
Practice Address - Country:US
Practice Address - Phone:479-452-6600
Practice Address - Fax:479-452-6692
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2010-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR31191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice