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General NPI Number Information
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NPI Number | 1265596597
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Entity Type | Organization
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Legal Business Name | BILL PICKARD, D.D.S., M.S., P.A.
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Dates
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Enumeration Date | 12/21/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1400 SE WALTON BLVD STE 42
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City | BENTONVILLE
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State | AR
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Zip | 72712-3202
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Country | US
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Telephone | 479-271-9944
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Fax | 479-271-9945
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Provider Business Mailing Address
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Address Line | 1400 SE WALTON BLVD STE 42
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City | BENTONVILLE
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State | AR
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Zip | 72712-3202
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Country | US
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Telephone | 479-271-9944
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Fax | 479-271-9945
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | DR. BILL PICKARD
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Credential | D.D.S., M.S., P.A.
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Telephone | 479-271-9944
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 2035
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License Number State | AR
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