Provider Demographics
NPI:1548393572
Name:WILLIAMS, EDWARD D (DMD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:D
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7700 CRITTENDEN ST
Mailing Address - Street 2:UNIT 33A
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19118-4421
Mailing Address - Country:US
Mailing Address - Phone:215-242-3141
Mailing Address - Fax:215-242-4212
Practice Address - Street 1:7700 CRITTENDEN ST
Practice Address - Street 2:UNIT 33A
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19118
Practice Address - Country:US
Practice Address - Phone:215-242-3141
Practice Address - Fax:215-242-4212
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS17842L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice