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General NPI Number Information
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NPI Number | 1003061300
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Entity Type | Individual
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Provider Name | DR. TONGELA LATARSHA WILLIAMS
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Gender | Female
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Dates
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Enumeration Date | 12/01/2008
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Last Update Date | 12/01/2008
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Provider Practice Location Address
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Address Line | 83 HIGH STREET SUITE A
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City | WALDORF
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State | MD
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Zip | 20602
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Country | US
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Telephone | 301-645-3501
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Fax | 301-705-5396
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Provider Business Mailing Address
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Address Line | 7622 OAKPOST CT
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City | UPPER MARLBORO
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State | MD
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Zip | 20772
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Country | US
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Telephone | 301-856-0079
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 13680
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DEN1000549
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License Number State | DC
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