Provider Demographics
NPI:1760735005
Name:WILLIAMS, MELISSA RENAE (DMD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:RENAE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:MELISSA
Other - Middle Name:RENAE
Other - Last Name:STERLING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:1045 WILLIAMSBURG RD
Mailing Address - Street 2:
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32720-1449
Mailing Address - Country:US
Mailing Address - Phone:386-490-8761
Mailing Address - Fax:
Practice Address - Street 1:1045 WILLIAMSBURG RD
Practice Address - Street 2:
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32720-1449
Practice Address - Country:US
Practice Address - Phone:386-490-8761
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1001429-15122300000X
NC10258122300000X
FLDN19983122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist