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General NPI Number Information
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NPI Number | 1124507975
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Entity Type | Organization
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Legal Business Name | WILLIAMSBURG SMILES
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Dates
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Enumeration Date | 08/13/2018
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Last Update Date | 08/13/2018
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Provider Practice Location Address
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Address Line | 400 ELM ST
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City | WILLIAMSBURG
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State | IA
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Zip | 52361-9406
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Country | US
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Telephone | 319-668-1221
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Fax |
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Provider Business Mailing Address
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Address Line | 1024 TOWER CT
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City | IOWA CITY
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State | IA
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Zip | 52246-3246
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Country | US
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Telephone | 319-330-3784
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MEGAN TIMM
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Credential | DDS
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Telephone | 319-330-3784
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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