Provider Demographics
NPI:1467731299
Name:WILLIAMSON, VICKI (RDH)
Entity Type:Individual
Prefix:MRS
First Name:VICKI
Middle Name:
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8550 W 38TH AVE
Mailing Address - Street 2:SUITE 306
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-4300
Mailing Address - Country:US
Mailing Address - Phone:303-467-8888
Mailing Address - Fax:303-467-8801
Practice Address - Street 1:360 PEAK ONE DRIVE
Practice Address - Street 2:SUITE 380
Practice Address - City:FRISCO
Practice Address - State:CO
Practice Address - Zip Code:80443
Practice Address - Country:US
Practice Address - Phone:970-668-8668
Practice Address - Fax:970-668-8689
Is Sole Proprietor?:No
Enumeration Date:2011-08-10
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO904326124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist