Provider Demographics
NPI:1003087958
Name:DR. CHADWICK L. WILLIAMS DMD PLLC
Entity Type:Organization
Organization Name:DR. CHADWICK L. WILLIAMS DMD PLLC
Other - Org Name:SMILE GALLERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHADWICK
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:615-444-2069
Mailing Address - Street 1:205 W HIGH ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37087-2264
Mailing Address - Country:US
Mailing Address - Phone:615-444-2069
Mailing Address - Fax:615-444-3706
Practice Address - Street 1:205 W HIGH ST
Practice Address - Street 2:SUITE 104
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-2264
Practice Address - Country:US
Practice Address - Phone:615-444-2069
Practice Address - Fax:615-444-3706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-19
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNTN78661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty