Provider Demographics
NPI:1235302746
Name:WILLIAMS, JOHN C (DDS MS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:C
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:DDS MS
Other - Prefix:
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Mailing Address - Street 1:206 MURRAY GUARD DRIVE
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305
Mailing Address - Country:US
Mailing Address - Phone:731-664-0080
Mailing Address - Fax:731-664-3259
Practice Address - Street 1:206 MURRAY GUARD DRIVE
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305
Practice Address - Country:US
Practice Address - Phone:731-664-0080
Practice Address - Fax:731-664-3259
Is Sole Proprietor?:No
Enumeration Date:2008-04-04
Last Update Date:2008-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS46471223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry