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General NPI Number Information
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NPI Number | 1619009933
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Entity Type | Individual
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Provider Name | CHRISTINE L. WILLIAMS DENTAL HYGIENIST
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Gender | Female
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Dates
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Enumeration Date | 03/12/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | DETROIT HEALTH DEPT. - HERMAN KIEFER HEALTH COMPLEX 1151 TAYLOR STREET, ADULT DENTAL CLINIC , WING 1C
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City | DETROIT
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State | MI
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Zip | 48202-1732
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Country | US
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Telephone | 313-876-4164
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Fax | 313-876-0177
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Provider Business Mailing Address
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Address Line | 4890 MARSEILLES ST
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City | DETROIT
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State | MI
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Zip | 48224-1451
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Country | US
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Telephone |
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 2902011188
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License Number State | MI
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