Provider Demographics
NPI:1932266160
Name:GURRAD, WILLIAM GORDON (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:GORDON
Last Name:GURRAD
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 1:10700 SE 174TH ST
Mailing Address - Street 2:SUITE #204
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-5472
Mailing Address - Country:US
Mailing Address - Phone:425-226-9565
Mailing Address - Fax:425-228-7544
Practice Address - Street 1:10700 SE 174TH ST
Practice Address - Street 2:SUITE #204
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-5472
Practice Address - Country:US
Practice Address - Phone:425-226-9565
Practice Address - Fax:425-228-7544
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA4932122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist