Provider Demographics
NPI:1619194792
Name:TIMOTHY WILLIAMS, DDS, MS, PLLC
Entity Type:Organization
Organization Name:TIMOTHY WILLIAMS, DDS, MS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:M
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:248-879-7200
Mailing Address - Street 1:6649 ROCHESTER RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48085-1389
Mailing Address - Country:US
Mailing Address - Phone:248-879-7200
Mailing Address - Fax:248-879-7091
Practice Address - Street 1:6649 ROCHESTER RD
Practice Address - Street 2:SUITE B
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48085-1389
Practice Address - Country:US
Practice Address - Phone:248-879-7200
Practice Address - Fax:248-879-7091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI106221223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty