Provider Demographics
NPI:1982687737
Name:BETHARDS, BILL N (DDS)
Entity Type:Individual
Prefix:DR
First Name:BILL
Middle Name:N
Last Name:BETHARDS
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 1:1019 24TH ST
Mailing Address - Street 2:
Mailing Address - City:ANACORTES
Mailing Address - State:WA
Mailing Address - Zip Code:98221-2586
Mailing Address - Country:US
Mailing Address - Phone:360-293-4695
Mailing Address - Fax:360-293-4813
Practice Address - Street 1:1019 24TH ST
Practice Address - Street 2:
Practice Address - City:ANACORTES
Practice Address - State:WA
Practice Address - Zip Code:98221-2586
Practice Address - Country:US
Practice Address - Phone:360-293-4695
Practice Address - Fax:360-293-4813
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA48301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice