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General NPI Number Information
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NPI Number | 1053414409
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Entity Type | Organization
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Legal Business Name | WILLIAM J WADDELL DDS
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Dates
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Enumeration Date | 09/07/2006
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Last Update Date | 10/05/2012
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Provider Practice Location Address
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Address Line | 9973 SAWMILL PARKWAY C
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City | POWELL
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State | OH
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Zip | 43065-7571
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Country | US
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Telephone | 614-764-1013
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Fax | 614-764-0174
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Provider Business Mailing Address
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Address Line | 9973 SAWMILL PARKWAY C
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City | POWELL
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State | OH
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Zip | 43065-7571
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Country | US
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Telephone | 614-764-1013
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Fax | 614-764-0174
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WILLIAM JOHN WADDELL
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Credential | DDS
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Telephone | 614-764-1013
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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