Provider Demographics
NPI:1689763005
Name:WILLIAMS II, ARTHUR E (DDS)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:E
Last Name:WILLIAMS II
Suffix:
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:PO BOX 35350
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48235-0350
Mailing Address - Country:US
Mailing Address - Phone:313-838-0480
Mailing Address - Fax:313-924-8262
Practice Address - Street 1:25101 COOLIDGE HWY
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:MI
Practice Address - Zip Code:48237-1404
Practice Address - Country:US
Practice Address - Phone:313-838-0480
Practice Address - Fax:313-838-4974
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI12594122300000X, 1223P0221X
TX241521223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4061443Medicaid