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General NPI Number Information
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NPI Number | 1851570634
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Entity Type | Organization
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Legal Business Name | WENDELL A WILLIAMS DDS
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Dates
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Enumeration Date | 10/30/2007
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Last Update Date | 10/30/2007
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Provider Practice Location Address
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Address Line | 5900 SHATTUCK AVE SUITE 202
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City | OAKLAND
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State | CA
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Zip | 94609-0742
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Country | US
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Telephone | 510-597-0337
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Fax | 510-597-0339
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Provider Business Mailing Address
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Address Line | 5900 SHATTUCK AVE SUITE 202
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City | OAKLAND
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State | CA
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Zip | 94609-0742
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Country | US
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Telephone | 510-597-0337
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Fax | 510-597-0339
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Authorized Official
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Title or Position | DENTIST
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Name | DR. WENDELL ALFRED WILLIAMS
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Credential | DDS
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Telephone | 510-597-0337
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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 | 36053
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License Number State | CA
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