Provider Demographics
NPI:1982826640
Name:CIAO, WILLIAM LOUIS (DMD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:LOUIS
Last Name:CIAO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19853 STATE ROUTE 2
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:WA
Mailing Address - Zip Code:98272-2352
Mailing Address - Country:US
Mailing Address - Phone:360-794-9055
Mailing Address - Fax:
Practice Address - Street 1:19853 STATE ROUTE 2
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:WA
Practice Address - Zip Code:98272-2352
Practice Address - Country:US
Practice Address - Phone:360-794-9055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA54021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5008610Medicaid