Provider Demographics
NPI:1366693251
Name:WILLIAMS, SCOTT ROWLEY (DMD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:ROWLEY
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2911 W 12TH STREET RD
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-5345
Mailing Address - Country:US
Mailing Address - Phone:970-353-2745
Mailing Address - Fax:
Practice Address - Street 1:3535 W 12TH ST
Practice Address - Street 2:SUITE B
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-2557
Practice Address - Country:US
Practice Address - Phone:970-351-6095
Practice Address - Fax:970-351-0155
Is Sole Proprietor?:No
Enumeration Date:2008-10-09
Last Update Date:2008-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9689122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist