Provider Demographics
NPI:1467547976
Name:WILLIAMS, LULA B (DDS)
Entity Type:Individual
Prefix:DR
First Name:LULA
Middle Name:B
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:LULA
Other - Middle Name:B
Other - Last Name:LANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:201 N MCGUIRE AVE
Mailing Address - Street 2:F
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71203-3859
Mailing Address - Country:US
Mailing Address - Phone:870-550-9299
Mailing Address - Fax:318-855-3235
Practice Address - Street 1:509 MAIN ST
Practice Address - Street 2:
Practice Address - City:DELHI
Practice Address - State:LA
Practice Address - Zip Code:71232-2537
Practice Address - Country:US
Practice Address - Phone:318-878-8965
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5160122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1851604Medicaid