Provider Demographics
NPI:1275903791
Name:KRISTY WILLIAMS RDHAP
Entity Type:Organization
Organization Name:KRISTY WILLIAMS RDHAP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTAL HYGIENIST
Authorized Official - Prefix:MS
Authorized Official - First Name:KRISTY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:RDH, RDHAP
Authorized Official - Phone:925-260-3997
Mailing Address - Street 1:21 EL MOLINO DR
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:CA
Mailing Address - Zip Code:94517-1705
Mailing Address - Country:US
Mailing Address - Phone:925-260-3997
Mailing Address - Fax:
Practice Address - Street 1:21 EL MOLINO DR
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:CA
Practice Address - Zip Code:94517-1705
Practice Address - Country:US
Practice Address - Phone:925-260-3997
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-26
Last Update Date:2015-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA595124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes124Q00000XDental ProvidersDental HygienistGroup - Single Specialty