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General NPI Number Information
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NPI Number | 1831746338
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Entity Type | Organization
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Legal Business Name | GARY WILLIAMS LLC
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Dates
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Enumeration Date | 08/20/2019
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Last Update Date | 08/20/2019
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Provider Practice Location Address
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Address Line | 100 MARKETPLACE DR STE B
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City | BYRAM
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State | MS
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Zip | 39272-8974
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Country | US
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Telephone | 601-665-4809
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Fax | 769-230-4973
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Provider Business Mailing Address
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Address Line | 100 MARKETPLACE DR
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City | BYRAM
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State | MS
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Zip | 39272-8974
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Country | US
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Telephone | 601-665-4809
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Fax |
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. GARY EUGENE WILLIAMS
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Credential | DMD
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Telephone | 601-665-4809
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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 |
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License Number State |
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