Provider Demographics
NPI:1134818941
Name:HOVANDER, WILLIAM SHELBY
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:SHELBY
Last Name:HOVANDER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1009 GLEN ST
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98020-2948
Mailing Address - Country:US
Mailing Address - Phone:425-331-9986
Mailing Address - Fax:
Practice Address - Street 1:11605 STATE AVE STE 108
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98271-8427
Practice Address - Country:US
Practice Address - Phone:360-386-9540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-08
Last Update Date:2025-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA614459491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice