Provider Demographics
NPI:1568587509
Name:WILLIAMS, ROBERT M (DDS PA)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:M
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:DDS PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6700 CROSSWINDS DR N STE 200C
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33710-8609
Mailing Address - Country:US
Mailing Address - Phone:727-345-6622
Mailing Address - Fax:727-345-3044
Practice Address - Street 1:6700 CROSSWINDS DR N STE 200C
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-8609
Practice Address - Country:US
Practice Address - Phone:727-345-6622
Practice Address - Fax:727-345-3044
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2012-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice