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General NPI Number Information
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NPI Number | 1285867176
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Entity Type | Organization
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Legal Business Name | CENTRAL TEXAS DENTAL CARE
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Dates
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Enumeration Date | 08/26/2009
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Last Update Date | 08/26/2009
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Provider Practice Location Address
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Address Line | 506 N HEWITT DR
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City | HEWITT
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State | TX
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Zip | 76643-3038
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Country | US
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Telephone | 254-666-1686
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Fax |
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Provider Business Mailing Address
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Address Line | 506 N HEWITT DR
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City | HEWITT
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State | TX
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Zip | 76643-3038
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Country | US
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Telephone | 254-666-1686
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Fax |
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Authorized Official
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Title or Position | DENTIST-OWNER
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Name | DR. DALE L WILLIAMS
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Credential | DDS
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Telephone | 254-666-1686
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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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