Provider Demographics
NPI:1326713645
Name:WILLIAMS, TONA COURRIER (DDS)
Entity Type:Individual
Prefix:DR
First Name:TONA
Middle Name:COURRIER
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:TONA
Other - Middle Name:SUE
Other - Last Name:COURRIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:1215 LYNMAR ST
Mailing Address - Street 2:
Mailing Address - City:KEYSER
Mailing Address - State:WV
Mailing Address - Zip Code:26726-2111
Mailing Address - Country:US
Mailing Address - Phone:304-788-2782
Mailing Address - Fax:304-788-2782
Practice Address - Street 1:1215 LYNMAR ST
Practice Address - Street 2:
Practice Address - City:KEYSER
Practice Address - State:WV
Practice Address - Zip Code:26726-2111
Practice Address - Country:US
Practice Address - Phone:304-788-2782
Practice Address - Fax:304-788-2782
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-10
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV33611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice