Provider Demographics
NPI:1548568181
Name:JILADA B. WILLIAMS, DDS, PC
Entity Type:Organization
Organization Name:JILADA B. WILLIAMS, DDS, PC
Other - Org Name:SONRISA DENTAL OF BOLINGBROOK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JILADA
Authorized Official - Middle Name:B
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:630-739-7200
Mailing Address - Street 1:PO BOX 539
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-0144
Mailing Address - Country:US
Mailing Address - Phone:630-739-7200
Mailing Address - Fax:630-739-7220
Practice Address - Street 1:168 N BOLINGBROOK DR
Practice Address - Street 2:
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60440-2350
Practice Address - Country:US
Practice Address - Phone:630-739-7200
Practice Address - Fax:630-739-7220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-07
Last Update Date:2011-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019018715261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental