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General NPI Number Information
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NPI Number | 1558689240
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Entity Type | Individual
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Provider Name | TIFFANY L WILLIAMS D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 05/06/2010
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Last Update Date | 07/13/2012
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Provider Practice Location Address
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Address Line | 521 N 11TH ST RM 317 DENT: PEDIATRICS
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City | RICHMOND
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State | VA
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Zip | 23298-5045
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Country | US
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Telephone | 804-828-1790
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Fax | 804-827-0163
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Provider Business Mailing Address
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Address Line | PO BOX 980566 DENT: PEDIATRICS
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City | RICHMOND
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State | VA
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Zip | 23298-0566
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Country | US
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Telephone | 804-828-1790
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Fax | 804-827-0163
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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 | AC5385578-R614
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | VA
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