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General NPI Number Information
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NPI Number | 1407842685
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Entity Type | Individual
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Provider Name | TOM MARTIN WILLIAMS DMD
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Gender | Male
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Dates
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Enumeration Date | 09/23/2005
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Last Update Date | 07/07/2020
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Provider Practice Location Address
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Address Line | 343 HOPE BAY LOOP
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City | APOLLO BEACH
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State | FL
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Zip | 33572-3533
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Country | US
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Telephone | 843-730-3418
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Fax |
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Provider Business Mailing Address
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Address Line | 11 MIDWAY DR
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City | HONOLULU
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State | HI
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Zip | 96818-3117
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Country | US
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Telephone | 808-778-8805
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 4368
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 4368
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 677
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License Number State | FL
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