Provider Demographics
NPI:1114320843
Name:MICHAEL T WILLIAMS DMD & MICHAEL O REIMELS DDS PLLC
Entity Type:Organization
Organization Name:MICHAEL T WILLIAMS DMD & MICHAEL O REIMELS DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, CBO
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:NOELLE
Authorized Official - Last Name:GROESCHEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-978-9800
Mailing Address - Street 1:PO BOX 2249
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28070-2249
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8801 J M KEYNES DR
Practice Address - Street 2:STE 275
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-8436
Practice Address - Country:US
Practice Address - Phone:704-547-8555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-08
Last Update Date:2014-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty