Provider Demographics
NPI:1609082510
Name:RON T WILLIAMSON DDS AND ASSOCIATES PLC
Entity Type:Organization
Organization Name:RON T WILLIAMSON DDS AND ASSOCIATES PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RONNIE
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:WILLIAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:248-399-4455
Mailing Address - Street 1:1964 W 11 MILE RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:BERKLEY
Mailing Address - State:MI
Mailing Address - Zip Code:48072-3046
Mailing Address - Country:US
Mailing Address - Phone:248-399-4455
Mailing Address - Fax:248-399-5622
Practice Address - Street 1:1964 W 11 MILE RD
Practice Address - Street 2:SUITE 4
Practice Address - City:BERKLEY
Practice Address - State:MI
Practice Address - Zip Code:48072-3046
Practice Address - Country:US
Practice Address - Phone:248-399-4455
Practice Address - Fax:248-399-5622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2013-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI013659122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty