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NPI Code Detail

MEDICARE: DR. BRENT A WILLIAMS DDS

MEDICARE: DR. BRENT A WILLIAMS DDS
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
11223G0001XGeneral Practice Dentistry19372OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1114086444
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRENT A WILLIAMS DDS
Provider Business Mailing Address
First Line : 1719 SECTION RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45237-3313
Country : US
Telephone Number : 513-531-4069
Fax Number : 513-531-4419
Provider Business Practice Location Address
First Line : 1719 SECTION RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45237-3313
Country : US
Telephone Number : 513-531-4069
Fax Number : 513-531-4419
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/06/2006
Last Update Date : 07/08/2007

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