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NPI Code Detail

MEDICARE: THOMAS P WILLIAMS DDS

MEDICARE: THOMAS P 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
11223S0112XOral and Maxillofacial Surgery (Dentist)05935IA
21223S0112XOral and Maxillofacial Surgery (Dentist)5000989015WI
31223S0112XOral and Maxillofacial Surgery (Dentist)23154CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
109100OTHERIABCBS DELTA DENTAL
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1780678466
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOMAS P WILLIAMS DDS
Provider Business Mailing Address
First Line : 100 BRYANT ST
Second Line :
City : DUBUQUE
State : IA
Zip : 52003-7405
Country : US
Telephone Number : 563-557-1440
Fax Number : 563-557-7001
Provider Business Practice Location Address
First Line : 100 BRYANT ST
Second Line :
City : DUBUQUE
State : IA
Zip : 52003-7405
Country : US
Telephone Number : 563-557-1440
Fax Number : 563-557-7001
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2005
Last Update Date : 07/08/2007

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Directions to “ THOMAS P WILLIAMS DDS” Practice Location

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