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General NPI Number Information
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NPI Number | 1194810788
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Entity Type | Individual
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Provider Name | TANYA JOPHAEL WILLIAMS DDS
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Gender | Female
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 05/08/2011
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Provider Practice Location Address
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Address Line | 4300 ROSEMEADE PKWY #1212
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City | DALLAS
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State | TX
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Zip | 75287-2976
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Country | US
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Telephone | 314-330-8096
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Fax |
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Provider Business Mailing Address
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Address Line | 4300 ROSEMEADE PKWY APT 1212
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City | DALLAS
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State | TX
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Zip | 75287-2976
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Country | US
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Telephone | 314-330-8096
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Fax | 770-892-5969
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DN012453
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 0026082
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License Number State | TX
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