MEDICARE: DR. STEPHEN B 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	1223P0106X	Oral and Maxillofacial Pathology Dentistry	18404	TX

General Provider Information

NPI Number	:	1700860160
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN B WILLIAMS DDS

Provider Business Mailing Address
First Line	:	1914 ELKHART ST
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20910-2153
Country	:	US
Telephone Number	:	301-587-6067
Fax Number	:

Provider Business Practice Location Address
First Line	:	AFIP, 6825 16TH ST NW
Second Line	:	BLDG 54, RM 3055
City	:	WASHINGTON
State	:	DC
Zip	:	20306-0001
Country	:	US
Telephone Number	:	202-782-1800
Fax Number	:

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

Provider Enumeration Date	:	11/30/2005
Last Update Date	:	07/08/2007

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