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General NPI Number Information
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NPI Number | 1235143579
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Entity Type | Organization
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Legal Business Name | JOHN D WILLIAMS DDS PA
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Dates
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Enumeration Date | 07/29/2006
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Last Update Date | 11/10/2008
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Provider Practice Location Address
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Address Line | 609 SW 8TH STREET #465
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City | BENTONVILLE
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State | AR
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Zip | 72712
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Country | US
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Telephone | 479-845-7250
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Fax | 479-845-7259
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Provider Business Mailing Address
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Address Line | 609 SW 8TH STREET #465
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City | BENTONVILLE
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State | AR
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Zip | 72712
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Country | US
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Telephone | 479-845-7250
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Fax | 479-845-7259
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Authorized Official
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Title or Position | OFFICER
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Name | DR. JOHN DAVID WILLIAMS
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Credential | DDS
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Telephone | 479-845-7250
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 25
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License Number State | AR
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