Provider Demographics
NPI:1336238690
Name:WILLIAMS, NICOLE K (DDS)
Entity type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:K
Last Name:WILLIAMS
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 1:1310 WAYNE MEMORIAL DR STE C
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534-2269
Mailing Address - Country:US
Mailing Address - Phone:919-881-0909
Mailing Address - Fax:919-881-0730
Practice Address - Street 1:1310 WAYNE MEMORIAL DR STE C
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-2269
Practice Address - Country:US
Practice Address - Phone:919-881-0909
Practice Address - Fax:919-881-0730
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC76681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice