Provider Demographics
NPI:1013156546
Name:WASH, WILLIAM J (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:J
Last Name:WASH
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 1:545 S YORK RD
Mailing Address - Street 2:
Mailing Address - City:BENSENVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60106-3000
Mailing Address - Country:US
Mailing Address - Phone:630-766-0115
Mailing Address - Fax:
Practice Address - Street 1:545 S YORK RD
Practice Address - Street 2:
Practice Address - City:BENSENVILLE
Practice Address - State:IL
Practice Address - Zip Code:60106-3000
Practice Address - Country:US
Practice Address - Phone:630-766-0115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-06
Last Update Date:2009-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-020688122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist