Provider Demographics
NPI:1205844875
Name:WILLIAMS-TURK, KATHELENE (DDS)
Entity Type:Individual
Prefix:
First Name:KATHELENE
Middle Name:
Last Name:WILLIAMS-TURK
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1235 8TH ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NM
Mailing Address - Zip Code:87701-4219
Mailing Address - Country:US
Mailing Address - Phone:805-688-9821
Mailing Address - Fax:805-688-3426
Practice Address - Street 1:2900 NOJOQUI AVE
Practice Address - Street 2:
Practice Address - City:LOS OLIVOS
Practice Address - State:CA
Practice Address - Zip Code:93441
Practice Address - Country:US
Practice Address - Phone:805-688-9821
Practice Address - Fax:805-688-3426
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD52211223G0001X
CA400411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty