Provider Demographics
NPI:1962588038
Name:BAUSCH, WILLIAM HAROLD (DDS)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:HAROLD
Last Name:BAUSCH
Suffix:
Gender:M
Credentials:DDS
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Mailing Address - Street 1:3575 JERSEY RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52807-2292
Mailing Address - Country:US
Mailing Address - Phone:563-355-7488
Mailing Address - Fax:563-355-7003
Practice Address - Street 1:3575 JERSEY RIDGE RD
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52807-2292
Practice Address - Country:US
Practice Address - Phone:563-355-7488
Practice Address - Fax:563-355-7003
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IA66231223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics