Provider Demographics
NPI:1932129814
Name:WILLIAMS, LAURA A (DMD)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:A
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 1:304 GRANT RD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:EAST WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98802-5384
Mailing Address - Country:US
Mailing Address - Phone:509-884-0353
Mailing Address - Fax:509-884-3453
Practice Address - Street 1:304 GRANT RD
Practice Address - Street 2:SUITE 5
Practice Address - City:EAST WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98802-5384
Practice Address - Country:US
Practice Address - Phone:509-884-0353
Practice Address - Fax:509-884-3453
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA65061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice