Healthcare Provider Details

I. General information

NPI: 1417964669
Provider Name (Legal Business Name): LOWELL DWAINE WILLIAMS DDS, MS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 01/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 N MAIN ST
HARRISON AR
72601-3536
US

IV. Provider business mailing address

500 N MAIN ST
HARRISON AR
72601-3536
US

V. Phone/Fax

Practice location:
  • Phone: 870-741-4746
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number1968
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: