Provider Demographics
NPI:1851471742
Name:KIRKPATRICK, WILLIAM DAVID (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:DAVID
Last Name:KIRKPATRICK
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 1:4040 DAYTON BLVD
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37415-7123
Mailing Address - Country:US
Mailing Address - Phone:423-870-5301
Mailing Address - Fax:
Practice Address - Street 1:4040 DAYTON BLVD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37415-7123
Practice Address - Country:US
Practice Address - Phone:423-870-5301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS35731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice