Provider Demographics
NPI:1326130717
Name:WILLIAMSON, LEWIS WALTER (DDS)
Entity Type:Individual
Prefix:DR
First Name:LEWIS
Middle Name:WALTER
Last Name:WILLIAMSON
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 1:1580 MAKALOA ST STE 725
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-3216
Mailing Address - Country:US
Mailing Address - Phone:808-973-3747
Mailing Address - Fax:808-973-3757
Practice Address - Street 1:1580 MAKALOA ST STE 725
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-3216
Practice Address - Country:US
Practice Address - Phone:808-973-3747
Practice Address - Fax:808-973-3757
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI10881223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery