Provider Demographics
NPI:1225185770
Name:WILLIAMS, DANIEL S (DDS)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:S
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 1:70 W MERCURY BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23669-2570
Mailing Address - Country:US
Mailing Address - Phone:757-722-2929
Mailing Address - Fax:757-722-5378
Practice Address - Street 1:70 W MERCURY BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23669-2570
Practice Address - Country:US
Practice Address - Phone:757-722-2929
Practice Address - Fax:757-722-5378
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010068111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
6811OtherDELTA DENTAL
524643OtherUNITED CORCORDIA INS.