MEDICARE: DR. BEN RICHARD 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
1	122300000X	Dentist	0000006828	TN

General Provider Information

NPI Number	:	1255545554
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BEN RICHARD WILLIAMS DDS

Provider Business Mailing Address
First Line	:	2863 STAGE CENTER DR
Second Line	:
City	:	BARTLETT
State	:	TN
Zip	:	38134-4679
Country	:	US
Telephone Number	:	901-372-0352
Fax Number	:

Provider Business Practice Location Address
First Line	:	2863 STAGE CENTER DR
Second Line	:
City	:	BARTLETT
State	:	TN
Zip	:	38134-4679
Country	:	US
Telephone Number	:	901-372-0352
Fax Number	:

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

Provider Enumeration Date	:	05/09/2007
Last Update Date	:	07/08/2007

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