Provider Demographics
NPI:1558574061
Name:WILLIAMS, MICHELE YVETTE (DMD)
Entity type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:YVETTE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1560 HIGHWAY 287 N STE 100
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-8824
Mailing Address - Country:US
Mailing Address - Phone:682-400-4777
Mailing Address - Fax:682-518-2808
Practice Address - Street 1:1560 HIGHWAY 287 N STE 100
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-8824
Practice Address - Country:US
Practice Address - Phone:682-400-4777
Practice Address - Fax:682-518-2808
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21987122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist