Provider Demographics
NPI:1689844094
Name:WILLIAMS FAMILY DENTISTRY PLLC.
Entity Type:Organization
Organization Name:WILLIAMS FAMILY DENTISTRY PLLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:OLIVER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:501-337-9212
Mailing Address - Street 1:PO BOX 278
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:AR
Mailing Address - Zip Code:72104-0278
Mailing Address - Country:US
Mailing Address - Phone:501-337-9212
Mailing Address - Fax:501-337-0280
Practice Address - Street 1:372 CORAL RD
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:AR
Practice Address - Zip Code:72104-7108
Practice Address - Country:US
Practice Address - Phone:501-337-9212
Practice Address - Fax:501-337-0280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-03
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty