Provider Demographics
NPI:1477614253
Name:WILLIAMS, ROBERT STEPHEN (DDS)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:STEPHEN
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6425 N PALM
Mailing Address - Street 2:SUITE #105
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93704
Mailing Address - Country:US
Mailing Address - Phone:559-439-6425
Mailing Address - Fax:559-439-5336
Practice Address - Street 1:6425 N PALM
Practice Address - Street 2:SUITE #105
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93704
Practice Address - Country:US
Practice Address - Phone:559-439-6425
Practice Address - Fax:559-439-5336
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26564122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist