Provider Demographics
NPI:1114042694
Name:WILLIAMS, ALVIN BERNARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALVIN
Middle Name:BERNARD
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 1:10508 KEEPSAKE CT
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772-2418
Mailing Address - Country:US
Mailing Address - Phone:301-877-9783
Mailing Address - Fax:301-877-1624
Practice Address - Street 1:9135 PISCATAWAY RD
Practice Address - Street 2:SUITE 105
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-2549
Practice Address - Country:US
Practice Address - Phone:301-877-1622
Practice Address - Fax:301-877-1624
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD109841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD001899600Medicaid