Provider Demographics
NPI:1154535649
Name:WILLIAMSON, COLLEEN (DDS)
Entity type:Individual
Prefix:DR
First Name:COLLEEN
Middle Name:
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:791 FOOTHILL CT
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-8507
Mailing Address - Country:US
Mailing Address - Phone:732-610-8286
Mailing Address - Fax:
Practice Address - Street 1:14 GRAND AVE
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-7504
Practice Address - Country:US
Practice Address - Phone:732-286-7000
Practice Address - Fax:732-286-4929
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2009-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02309300122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist