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General NPI Number Information
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NPI Number | 1013007327
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Entity Type | Organization
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Legal Business Name | ROGER C WILLIAMS DDS, INC
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Dates
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Enumeration Date | 10/15/2006
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Last Update Date | 07/29/2007
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Provider Practice Location Address
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Address Line | 2750 DOVER CENTER RD
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City | WESTLAKE
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State | OH
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Zip | 44145-4501
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Country | US
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Telephone | 440-835-7272
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Fax | 440-835-7269
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Provider Business Mailing Address
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Address Line | 2750 DOVER CENTER RD
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City | WESTLAKE
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State | OH
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Zip | 44145-4501
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Country | US
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Telephone | 440-835-7272
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Fax | 440-835-7269
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROGER C WILLIAMS
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Credential | DDS
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Telephone | 440-835-7272
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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 | 14348
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License Number State | OH
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