MEDICARE: DR. NEIL S WILLIAMS DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	60764	CA

General Provider Information

NPI Number	:	1053693911
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NEIL S WILLIAMS DMD

Provider Business Mailing Address
First Line	:	15788 SWEET LEMON WAY
Second Line	:
City	:	WINTER GARDEN
State	:	FL
Zip	:	34787-3366
Country	:	US
Telephone Number	:	978-697-0715
Fax Number	:

Provider Business Practice Location Address
First Line	:	15788 SWEET LEMON WAY
Second Line	:
City	:	WINTER GARDEN
State	:	FL
Zip	:	34787-3366
Country	:	US
Telephone Number	:	978-697-0715
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/15/2011
Last Update Date	:	06/10/2026

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