Provider Demographics
NPI:1922196542
Name:WIGGINS, WILLIAM SCOTT (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:SCOTT
Last Name:WIGGINS
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 1:8012 112TH ST COURT EAST
Mailing Address - Street 2:SUITE 340
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98373-7856
Mailing Address - Country:US
Mailing Address - Phone:253-840-0789
Mailing Address - Fax:253-841-6832
Practice Address - Street 1:8012 112TH ST COURT EAST
Practice Address - Street 2:SUITE 340
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98373-7856
Practice Address - Country:US
Practice Address - Phone:253-840-0789
Practice Address - Fax:253-841-6832
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice