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General NPI Number Information
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NPI Number | 1710035886
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Entity Type | Individual
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Provider Name | BENJAMIN D WILLIAMS D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 12/22/2011
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Provider Practice Location Address
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Address Line | 3727 N GOLDENROD RD STE 108
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City | WINTER PARK
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State | FL
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Zip | 32792-8611
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Country | US
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Telephone | 205-591-1101
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Fax |
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Provider Business Mailing Address
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Address Line | 508 LANGHOLM DR
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City | WINTER PARK
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State | FL
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Zip | 32789-5253
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 5495
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | DN17571
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License Number State | FL
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