Provider Demographics
NPI:1487726758
Name:WILLIAMS DENTAL GROUP PC
Entity type:Organization
Organization Name:WILLIAMS DENTAL GROUP PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CO OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CURTIS
Authorized Official - Middle Name:LEVY
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:SR
Authorized Official - Credentials:DDS
Authorized Official - Phone:301-630-5502
Mailing Address - Street 1:4302 ST BARNABAS RD
Mailing Address - Street 2:SUITES C & F
Mailing Address - City:TEMPLE HILLS
Mailing Address - State:MD
Mailing Address - Zip Code:20748
Mailing Address - Country:US
Mailing Address - Phone:301-630-5502
Mailing Address - Fax:301-630-0287
Practice Address - Street 1:4302 ST BARNABAS RD
Practice Address - Street 2:SUITES C & F
Practice Address - City:TEMPLE HILLS
Practice Address - State:MD
Practice Address - Zip Code:20748
Practice Address - Country:US
Practice Address - Phone:301-630-5502
Practice Address - Fax:301-630-0287
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD77791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty