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General NPI Number Information
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NPI Number | 1013633247
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Entity Type | Organization
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Legal Business Name | WILLIAMS DENTAL P C
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Dates
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Enumeration Date | 10/19/2022
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Last Update Date | 10/19/2022
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Provider Practice Location Address
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Address Line | 4302 W CRYSTAL LAKE RD STE J
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City | MCHENRY
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State | IL
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Zip | 60050-4248
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Country | US
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Telephone | 815-385-0777
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Fax |
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Provider Business Mailing Address
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Address Line | 4302 W CRYSTAL LAKE RD STE J
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City | MCHENRY
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State | IL
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Zip | 60050-4248
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Country | US
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Telephone | 815-385-0777
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DEEPA Y WILLIAMS
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Credential |
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Telephone | 747-344-9800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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