Provider Demographics
NPI:1659797918
Name:WILLIAMS, AMANDA CHRISTIAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:CHRISTIAN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 GODWIN DR
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTON
Mailing Address - State:NC
Mailing Address - Zip Code:27892-6828
Mailing Address - Country:US
Mailing Address - Phone:504-236-6062
Mailing Address - Fax:
Practice Address - Street 1:1130 GODWIN DR
Practice Address - Street 2:
Practice Address - City:WILLIAMSTON
Practice Address - State:NC
Practice Address - Zip Code:27892-6828
Practice Address - Country:US
Practice Address - Phone:252-789-0401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-11
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NC9981122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program