Provider Demographics
NPI:1225147861
Name:WILLIAMS, JAMES BURRELL III (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:BURRELL
Last Name:WILLIAMS
Suffix:III
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:310 EISENHOWER DR STE 2
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-2632
Mailing Address - Country:US
Mailing Address - Phone:912-351-0615
Mailing Address - Fax:912-354-6555
Practice Address - Street 1:310 EISENHOWER DR STE 2
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-2632
Practice Address - Country:US
Practice Address - Phone:912-351-0615
Practice Address - Fax:912-354-6555
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA0105291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00349346BMedicaid