Provider Demographics
NPI:1063026177
Name:WILLIAMS, SETH HAVEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:SETH
Middle Name:HAVEN
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7229 ROCHESTER DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-1523
Mailing Address - Country:US
Mailing Address - Phone:915-497-3902
Mailing Address - Fax:
Practice Address - Street 1:1715 WESTON BRENT LN
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79935-3013
Practice Address - Country:US
Practice Address - Phone:915-497-3902
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-04
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX365101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice