Provider Demographics
NPI:1639391253
Name:R. SCOTT WILLIAMS, D.D.S., P.S.
Entity Type:Organization
Organization Name:R. SCOTT WILLIAMS, D.D.S., P.S.
Other - Org Name:NONE
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:R.
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:509-882-3151
Mailing Address - Street 1:201 EUCLID STREET
Mailing Address - Street 2:
Mailing Address - City:GRANDVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98930
Mailing Address - Country:US
Mailing Address - Phone:509-882-3151
Mailing Address - Fax:509-882-2603
Practice Address - Street 1:201 EUCLID STREET
Practice Address - Street 2:
Practice Address - City:GRANDVIEW
Practice Address - State:WA
Practice Address - Zip Code:98930
Practice Address - Country:US
Practice Address - Phone:509-882-3151
Practice Address - Fax:509-882-2603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA59731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty