Provider Demographics
NPI:1679620124
Name:NASH, WILLIAM ALAN (DDS)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ALAN
Last Name:NASH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 24TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79410-1830
Mailing Address - Country:US
Mailing Address - Phone:806-793-0421
Mailing Address - Fax:806-793-1692
Practice Address - Street 1:3801 24TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410-1830
Practice Address - Country:US
Practice Address - Phone:806-793-0421
Practice Address - Fax:806-793-1692
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX112041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice