Provider Demographics
NPI:1992171672
Name:HAWKS, WILLIAM CLINTON JR (DMD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:CLINTON
Last Name:HAWKS
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47932-1260
Mailing Address - Country:US
Mailing Address - Phone:859-475-4695
Mailing Address - Fax:
Practice Address - Street 1:1302 PEARL ST
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:IN
Practice Address - Zip Code:47932-9760
Practice Address - Country:US
Practice Address - Phone:765-793-4680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-17
Last Update Date:2021-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12013383A122300000X
KY9596122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist