Provider Demographics
NPI:1497899942
Name:WILLIAMSON, BENJAMIN CLAY (DDS)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:CLAY
Last Name:WILLIAMSON
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 1:5325 SARATOGA BLVD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78413-2836
Mailing Address - Country:US
Mailing Address - Phone:361-994-7645
Mailing Address - Fax:361-994-7646
Practice Address - Street 1:5325 SARATOGA BLVD
Practice Address - Street 2:SUITE 230
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78413-2836
Practice Address - Country:US
Practice Address - Phone:361-994-7645
Practice Address - Fax:361-994-7646
Is Sole Proprietor?:No
Enumeration Date:2007-02-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX208801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice