Provider Demographics
NPI:1558647305
Name:WILLIAMS, NITALYA B (DDS)
Entity Type:Individual
Prefix:DR
First Name:NITALYA
Middle Name:B
Last Name:WILLIAMS
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Gender:F
Credentials:DDS
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Mailing Address - Street 1:8700 NE VANCOUVER MALL DR
Mailing Address - Street 2:SUITE 202A
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98662-6750
Mailing Address - Country:US
Mailing Address - Phone:360-254-8880
Mailing Address - Fax:360-254-8385
Practice Address - Street 1:8700 NE VANCOUVER MALL DR
Practice Address - Street 2:SUITE 202A
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98662-6750
Practice Address - Country:US
Practice Address - Phone:360-254-8880
Practice Address - Fax:360-254-8385
Is Sole Proprietor?:No
Enumeration Date:2011-10-25
Last Update Date:2011-10-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WADE602501071223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics