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General NPI Number Information
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NPI Number | 1598133225
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Entity Type | Organization
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Legal Business Name | WILLIAMS & BUSH PARTNERSHIP
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Dates
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Enumeration Date | 09/11/2015
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Last Update Date | 09/11/2015
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Provider Practice Location Address
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Address Line | 108 W POPE ST
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City | SYLVESTER
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State | GA
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Zip | 31791-2030
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Country | US
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Telephone | 229-776-6431
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Fax | 229-776-4295
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Provider Business Mailing Address
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Address Line | 108 W POPE ST
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City | SYLVESTER
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State | GA
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Zip | 31791-2030
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Country | US
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Telephone | 229-776-6431
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Fax | 229-776-4295
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Authorized Official
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Title or Position | PARTNER
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Name | JAY A WILLIAMS
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Credential |
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Telephone | 229-776-6431
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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 | 011272
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License Number State | GA
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