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NPI Code Detail

MEDICARE: DR. MARK J WILLIAMSON D.D.S.

MEDICARE: DR. MARK J WILLIAMSON D.D.S.
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 Dentistry2901013535MI

General Provider Information

NPI Number : 1851341945
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARK J WILLIAMSON D.D.S.
Provider Business Mailing Address
First Line : PO BOX 210
Second Line :
City : FLUSHING
State : MI
Zip : 48433-0210
Country : US
Telephone Number : 810-659-4561
Fax Number : 810-659-0897
Provider Business Practice Location Address
First Line : 4279 W VIENNA RD
Second Line :
City : CLIO
State : MI
Zip : 48420-9440
Country : US
Telephone Number : 810-659-1721
Fax Number : 810-659-0897
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2006
Last Update Date : 12/19/2019

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