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General NPI Number Information
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NPI Number | 1558647305
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Entity Type | Individual
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Provider Name | NITALYA B WILLIAMS DDS
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Gender | Female
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Dates
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Enumeration Date | 10/25/2011
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Last Update Date | 11/06/2024
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Provider Practice Location Address
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Address Line | 801 N WILMOT RD STE F2
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City | TUCSON
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State | AZ
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Zip | 85711-1700
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Country | US
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Telephone | 520-745-5051
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Fax |
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Provider Business Mailing Address
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Address Line | 311 VIA SAN SEBASTIAN
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City | REDONDO BEACH
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State | CA
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Zip | 90277-6659
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Country | US
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Telephone | 818-261-1345
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 109582
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License Number State | CA
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