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General NPI Number Information
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NPI Number | 1164978227
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Entity Type | Organization
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Legal Business Name | WILLIAM RADFORD JR DDS PLLC
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Dates
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Enumeration Date | 08/29/2016
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Last Update Date | 08/29/2016
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Provider Practice Location Address
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Address Line | 1550 N BRIDGE ST
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City | ELKIN
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State | NC
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Zip | 28621-2202
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Country | US
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Telephone | 336-258-2745
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Fax | 336-258-2746
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Provider Business Mailing Address
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Address Line | 1550 N BRIDGE ST
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City | ELKIN
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State | NC
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Zip | 28621-2202
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Country | US
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Telephone | 336-258-2745
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Fax | 336-258-2746
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. WILLIAM HUBERT RADFORD JR.
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Credential | D.D.S.
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Telephone | 919-210-7769
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 8888
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License Number State | NC
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