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General NPI Number Information
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NPI Number | 1235453457
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Entity Type | Organization
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Legal Business Name | WILLIAM C BIGELOW, D.D.S., PC
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Dates
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Enumeration Date | 03/17/2010
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Last Update Date | 03/17/2010
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Provider Practice Location Address
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Address Line | 110 MACTANLY PL STE C
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City | STAUNTON
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State | VA
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Zip | 24401-2362
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Country | US
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Telephone | 540-213-8750
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Fax | 540-213-8753
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Provider Business Mailing Address
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Address Line | 110 MACTANLY PL STE C
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City | STAUNTON
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State | VA
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Zip | 24401-2362
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Country | US
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Telephone | 540-213-8750
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Fax | 540-213-8753
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Authorized Official
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Title or Position | OWNER
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Name | DR. WILLIAM C BIGELOW
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Credential | D.D.S.
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Telephone | 540-213-8750
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 0438000074
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License Number State | VA
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