Provider Demographics
NPI:1306025580
Name:WILLIAMS, LESLIE F RICK (DDS)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:F RICK
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:RICK
Other - Middle Name:
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2102 PECOS
Mailing Address - Street 2:SUITE 6
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76901-3061
Mailing Address - Country:US
Mailing Address - Phone:325-944-4984
Mailing Address - Fax:325-942-0192
Practice Address - Street 1:2102 PECOS
Practice Address - Street 2:SUITE 6
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76901-3061
Practice Address - Country:US
Practice Address - Phone:325-944-4984
Practice Address - Fax:325-942-0192
Is Sole Proprietor?:No
Enumeration Date:2007-10-24
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD09960122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist