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General NPI Number Information
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NPI Number | 1649521097
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Entity Type | Organization
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Legal Business Name | NATHAN W. WARD, DDS, PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 09/25/2012
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Last Update Date | 09/25/2012
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Provider Practice Location Address
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Address Line | 24 ALEXANDER ST
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City | WATSONVILLE
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State | CA
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Zip | 95076-4609
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Country | US
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Telephone | 831-728-0232
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Fax |
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Provider Business Mailing Address
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Address Line | 24 ALEXANDER ST
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City | WATSONVILLE
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State | CA
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Zip | 95076-4609
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Country | US
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Telephone | 831-728-0232
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. NATHAN W WARD
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Credential | DDS
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Telephone | 831-728-0232
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 59615
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 59615
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License Number State | CA
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