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NPI Code Detail

MEDICARE: DR. NICHOLAS WILLIAMS SR.

MEDICARE: DR. NICHOLAS WILLIAMS SR.
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 Dentistry57100CA

General Provider Information

NPI Number : 1639330962
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NICHOLAS WILLIAMS SR.
Provider Business Mailing Address
First Line : 4401 FLORIN RD
Second Line :
City : SACRAMENTO
State : CA
Zip : 95823-2511
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4401 FLORIN RD
Second Line :
City : SACRAMENTO
State : CA
Zip : 95823-2511
Country : US
Telephone Number : 916-428-4000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2008
Last Update Date : 06/19/2008

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