Provider Demographics
NPI:1689688814
Name:WILLIAMS, HARRY BOYD JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:HARRY
Middle Name:BOYD
Last Name:WILLIAMS
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 LAUREL ST
Mailing Address - Street 2:P. O. BOX 744
Mailing Address - City:BREMEN
Mailing Address - State:GA
Mailing Address - Zip Code:30110-2124
Mailing Address - Country:US
Mailing Address - Phone:770-537-4439
Mailing Address - Fax:770-537-3708
Practice Address - Street 1:302 LAUREL ST
Practice Address - Street 2:
Practice Address - City:BREMEN
Practice Address - State:GA
Practice Address - Zip Code:30110-2124
Practice Address - Country:US
Practice Address - Phone:770-537-4439
Practice Address - Fax:770-537-3708
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA73891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice