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General NPI Number Information
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NPI Number | 1760642292
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Entity Type | Individual
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Provider Name | LEOTIS WILLIAMS DMD
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Gender | Male
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Dates
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Enumeration Date | 06/09/2008
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Last Update Date | 02/05/2014
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Provider Practice Location Address
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Address Line | 5227 BESSEMER HIGHWAY STE A
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City | BESSEMER
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State | AL
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Zip | 35020
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Country | US
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Telephone | 205-424-0029
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Fax | 205-425-0069
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Provider Business Mailing Address
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Address Line | PO BOX 28244
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City | BIRMINGHAM
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State | AL
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Zip | 35228
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Country | US
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Telephone | 205-424-0029
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Fax | 205-425-0069
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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 | LNO 3979
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License Number State | AL
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