Provider Demographics
NPI:1841393212
Name:WILLIAMS, TROY ALAN (DDS MDS)
Entity Type:Individual
Prefix:
First Name:TROY
Middle Name:ALAN
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:DDS MDS
Other - Prefix:DR
Other - First Name:TROY
Other - Middle Name:ALAN
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS MDS
Mailing Address - Street 1:1431 NORTH FILLMORE ST
Mailing Address - Street 2:STE 100
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83341
Mailing Address - Country:US
Mailing Address - Phone:208-737-0006
Mailing Address - Fax:208-734-2630
Practice Address - Street 1:1431 NORTH FILLMORE ST
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83341
Practice Address - Country:US
Practice Address - Phone:208-737-0006
Practice Address - Fax:208-734-2630
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDD-3602-OR1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics