Healthcare Provider Details

I. General information

NPI: 1255263307
Provider Name (Legal Business Name): NW DENTISTRY AND SPECIALTIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5885 GLENRIDGE DR STE 160
SANDY SPRINGS GA
30328-6171
US

IV. Provider business mailing address

12070 S MAGNOLIA CIR
JOHNS CREEK GA
30005-6720
US

V. Phone/Fax

Practice location:
  • Phone: 470-470-3980
  • Fax: 470-470-3544
Mailing address:
  • Phone: 912-224-4890
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: DR. NATHANIEL ANTWAN WILLIAMS
Title or Position: OWNER
Credential: DDS
Phone: 912-224-4890