Provider Demographics
NPI:1639162563
Name:WILLIAMS, MARIE YVETTE ANGELA (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:MARIE
Middle Name:YVETTE ANGELA
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
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Mailing Address - Street 1:1520 KATRINA PL
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-2514
Mailing Address - Country:US
Mailing Address - Phone:334-356-2349
Mailing Address - Fax:
Practice Address - Street 1:300 S TWINING STREET
Practice Address - Street 2:BLDG 760
Practice Address - City:MAXWELL AFB
Practice Address - State:AL
Practice Address - Zip Code:36112-6219
Practice Address - Country:US
Practice Address - Phone:334-953-7821
Practice Address - Fax:334-953-1606
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY38728-11223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics