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NPI Code Detail

MEDICARE: ALLEN RIDDICK WILLIAMS D.D.S.

MEDICARE: ALLEN RIDDICK WILLIAMS D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist32221TX

General Provider Information

NPI Number : 1083160980
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALLEN RIDDICK WILLIAMS D.D.S.
Provider Business Mailing Address
First Line : 701 W BAILEY BOSWELL RD
Second Line :
City : SAGINAW
State : TX
Zip : 76179-1007
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 701 W BAILEY BOSWELL RD
Second Line :
City : SAGINAW
State : TX
Zip : 76179-1007
Country : US
Telephone Number : 817-367-6453
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2016
Last Update Date : 08/30/2016

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