MEDICARE: JOHN STUART WILLIAMS, DDS, P.A.

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

General Provider Information

NPI Number	:	1285224535
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHN STUART WILLIAMS, DDS, P.A.

Provider Business Mailing Address
First Line	:	2897 W HIGHWAY 74
Second Line	:
City	:	MONROE
State	:	NC
Zip	:	28110-8434
Country	:	US
Telephone Number	:	704-225-9823
Fax Number	:

Provider Business Practice Location Address
First Line	:	2897 W HIGHWAY 74
Second Line	:
City	:	MONROE
State	:	NC
Zip	:	28110-8434
Country	:	US
Telephone Number	:	704-225-9823
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JOHN STUART WILLIAMS
Credential	:	DDS
Telephone Number	:	704-225-9823

Provider Enumeration Date	:	01/21/2021
Last Update Date	:	01/21/2021

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