Healthcare Provider Details
I. General information
NPI: 1417694845
Provider Name (Legal Business Name): STEVE AND HARLEY WILLIAMS DDS PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/17/2022
Last Update Date: 05/02/2023
Certification Date: 05/02/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
999 E STANLEY BLVD STE C
LIVERMORE CA
94550-4050
US
IV. Provider business mailing address
999 E STANLEY BLVD STE C
LIVERMORE CA
94550-4050
US
V. Phone/Fax
- Phone: 925-371-0300
- Fax:
- Phone: 925-371-0300
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223E0200X |
| Taxonomy | Endodontics |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1223P0300X |
| Taxonomy | Periodontics |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
VICENTA
REYES
Title or Position: LEAD OF CREDENTIALING
Credential:
Phone: 972-869-3789