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NPI Code Detail

MEDICARE: JAY CHRISTOPHER WILLIAMS DDS

MEDICARE: JAY CHRISTOPHER WILLIAMS DDS
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
11223G0001XGeneral Practice DentistryD11159MN

General Provider Information

NPI Number : 1396720884
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAY CHRISTOPHER WILLIAMS DDS
Provider Business Mailing Address
First Line : 2218 LAUREL AVE
Second Line : MILL CITY DENTAL
City : MINNEAPOLIS
State : MN
Zip : 55405-1909
Country : US
Telephone Number : 612-377-3740
Fax Number : 612-377-5004
Provider Business Practice Location Address
First Line : 2218 LAUREL AVE
Second Line : MILL CITY DENTAL
City : MINNEAPOLIS
State : MN
Zip : 55405-1909
Country : US
Telephone Number : 612-377-3740
Fax Number : 612-377-5004
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/07/2005
Last Update Date : 07/08/2007

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