Provider Demographics
NPI:1326110040
Name:MICHAEL D WILLIAMS,DDS,PA
Entity Type:Organization
Organization Name:MICHAEL D WILLIAMS,DDS,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:954-476-4537
Mailing Address - Street 1:131 NW 100TH AVE
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-7034
Mailing Address - Country:US
Mailing Address - Phone:954-476-4537
Mailing Address - Fax:954-476-7734
Practice Address - Street 1:131 NW 100TH AVE
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-7034
Practice Address - Country:US
Practice Address - Phone:954-476-4537
Practice Address - Fax:954-476-7734
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN53671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty