Provider Demographics
NPI:1225119480
Name:THOMAS H. WILLIAMS III DMD, PC
Entity Type:Organization
Organization Name:THOMAS H. WILLIAMS III DMD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:H
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:III
Authorized Official - Credentials:DMD
Authorized Official - Phone:334-277-9570
Mailing Address - Street 1:5740 CARMICHAEL RD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-2312
Mailing Address - Country:US
Mailing Address - Phone:334-277-9570
Mailing Address - Fax:334-277-0152
Practice Address - Street 1:5740 CARMICHAEL RD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-2312
Practice Address - Country:US
Practice Address - Phone:334-277-9570
Practice Address - Fax:334-277-0152
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL33721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51097601OtherBLUE CROSS BLUE SHIELD
AL84432OtherUNITED CONCORDIA
AL92234Medicare UPIN