Provider Demographics
NPI:1891790812
Name:BILLY DON CARD, JR., DDS, MS, PS
Entity Type:Organization
Organization Name:BILLY DON CARD, JR., DDS, MS, PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BILLY
Authorized Official - Middle Name:DON
Authorized Official - Last Name:CARD
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:509-663-6883
Mailing Address - Street 1:620 N EMERSON AVE
Mailing Address - Street 2:STE 102
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-6619
Mailing Address - Country:US
Mailing Address - Phone:509-663-6883
Mailing Address - Fax:509-662-8741
Practice Address - Street 1:620 N EMERSON AVE
Practice Address - Street 2:STE 102
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-6619
Practice Address - Country:US
Practice Address - Phone:509-663-6883
Practice Address - Fax:509-662-8741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-16
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA85901223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0141944OtherLABOR & INDUSTRIES
WA238OtherWDS CLIENT #
WA8925622OtherCRIME VICTIMS COMP. PROG.
WADE 00008590OtherSTATE DENTAL LICENSE