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General NPI Number Information
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NPI Number | 1376282202
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Entity Type | Individual
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Provider Name | KALEB WILLIAMSON DDS
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Gender | Male
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Dates
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Enumeration Date | 05/31/2022
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Last Update Date | 05/17/2024
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Provider Practice Location Address
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Address Line | 2929 COLLEGE DR
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City | BATON ROUGE
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State | LA
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Zip | 70808-3204
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Country | US
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Telephone | 225-372-3117
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Fax |
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Provider Business Mailing Address
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Address Line | 128 PINEY CV
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City | WEST MONROE
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State | LA
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Zip | 71291-7461
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Country | US
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Telephone | 318-557-7102
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Fax |
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 7343
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License Number State | LA
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