Healthcare Provider Details

I. General information

NPI: 1912017765
Provider Name (Legal Business Name): JAMES R WILLIAMS DDS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11610 N SAGINAW ST
MT MORRIS MI
48458
US

IV. Provider business mailing address

11610 N SAGINAW ST
MT MORRIS MI
48458
US

V. Phone/Fax

Practice location:
  • Phone: 810-686-8460
  • Fax: 810-686-4098
Mailing address:
  • Phone: 810-686-8460
  • Fax: 810-686-4098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number2901013013
License Number StateMI

VIII. Authorized Official

Name: DR. JAMES RAYMOND WILLIAMS III
Title or Position: PRESIDENT
Credential: DDS
Phone: 810-686-8460