Provider Demographics
NPI:1851311534
Name:WILLIAMS, THOMAS CHENEY (DMD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:CHENEY
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:265 N JEFF DAVIS DR
Mailing Address - Street 2:SUITE #1
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30214-1625
Mailing Address - Country:US
Mailing Address - Phone:678-817-5900
Mailing Address - Fax:678-817-1775
Practice Address - Street 1:265 N JEFF DAVIS DR
Practice Address - Street 2:SUITE #1
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-1625
Practice Address - Country:US
Practice Address - Phone:678-817-5900
Practice Address - Fax:678-817-1775
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2010-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA84641223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist