Provider Demographics
NPI:1104917848
Name:WILLIAMS DDS PA
Entity type:Organization
Organization Name:WILLIAMS DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PART OWNER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:M.
Authorized Official - Middle Name:CRAIG
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:919-846-9070
Mailing Address - Street 1:6837 FALLS OF NEUSE RD
Mailing Address - Street 2:STE. 200
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-5308
Mailing Address - Country:US
Mailing Address - Phone:919-846-9070
Mailing Address - Fax:919-846-9552
Practice Address - Street 1:6837 FALLS OF NEUSE RD
Practice Address - Street 2:STE. 200
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-5308
Practice Address - Country:US
Practice Address - Phone:919-846-9070
Practice Address - Fax:919-846-9552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3742122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty