Provider Demographics
NPI:1467897116
Name:WILLIAMS, THOMAS HARRIS III (DMD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:HARRIS
Last Name:WILLIAMS
Suffix:III
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 1:5740 CARMICHAEL RD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-2312
Mailing Address - Country:US
Mailing Address - Phone:334-277-9570
Mailing Address - Fax:334-277-9570
Practice Address - Street 1:5740 CARMICHAEL RD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-2312
Practice Address - Country:US
Practice Address - Phone:334-277-9570
Practice Address - Fax:334-277-9570
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-08
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3372122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL92234Medicare UPIN