Provider Demographics
NPI:1285850370
Name:HARRIS, BILL D (DDS,MS)
Entity type:Individual
Prefix:DR
First Name:BILL
Middle Name:D
Last Name:HARRIS
Suffix:
Gender:M
Credentials:DDS,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 EAST ST
Mailing Address - Street 2:
Mailing Address - City:HEALDSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:95448-3929
Mailing Address - Country:US
Mailing Address - Phone:707-433-4829
Mailing Address - Fax:707-433-4848
Practice Address - Street 1:409 EAST ST
Practice Address - Street 2:
Practice Address - City:HEALDSBURG
Practice Address - State:CA
Practice Address - Zip Code:95448-3929
Practice Address - Country:US
Practice Address - Phone:707-433-4829
Practice Address - Fax:707-433-4848
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD210161223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics