Provider Demographics
NPI:1609009463
Name:WILLIAMS, TOSHA RENAE (DDS)
Entity Type:Individual
Prefix:DR
First Name:TOSHA
Middle Name:RENAE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:TOSHA
Other - Middle Name:RENAE
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:13235 SW 111TH TER
Mailing Address - Street 2:APT #3
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-7935
Mailing Address - Country:US
Mailing Address - Phone:305-898-0302
Mailing Address - Fax:
Practice Address - Street 1:10300 SW 216TH ST
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33190-1003
Practice Address - Country:US
Practice Address - Phone:305-253-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-27
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN19661122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist