Provider Demographics
NPI:1538362975
Name:EICH, WILLIAM CHARLES (DDS)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:CHARLES
Last Name:EICH
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 1:1799 N WATERMAN AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92404-5107
Mailing Address - Country:US
Mailing Address - Phone:909-883-4226
Mailing Address - Fax:909-883-5718
Practice Address - Street 1:1799 N WATERMAN AVE
Practice Address - Street 2:SUITE C
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92404-5107
Practice Address - Country:US
Practice Address - Phone:909-883-4226
Practice Address - Fax:909-883-5718
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA367491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice