Provider Demographics
NPI:1083712798
Name:WILLIAMS, KARRIE TIEPPO (DDS)
Entity Type:Individual
Prefix:DR
First Name:KARRIE
Middle Name:TIEPPO
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:KARRIE
Other - Middle Name:TIEPPO
Other - Last Name:ROYCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:100 SHERWOOD DR.
Mailing Address - Street 2:
Mailing Address - City:ROSCOMMON
Mailing Address - State:MI
Mailing Address - Zip Code:48653
Mailing Address - Country:US
Mailing Address - Phone:989-275-1919
Mailing Address - Fax:989-275-1619
Practice Address - Street 1:100 SHERWOOD DR.
Practice Address - Street 2:
Practice Address - City:ROSCOMMON
Practice Address - State:MI
Practice Address - Zip Code:48653
Practice Address - Country:US
Practice Address - Phone:989-275-1919
Practice Address - Fax:989-275-1619
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI175071223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice