Provider Demographics
NPI:1851475305
Name:WILLIAMS, JOHN A JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:A
Last Name:WILLIAMS
Suffix:JR
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 1:1457 RARITAN RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CLARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07066-1252
Mailing Address - Country:US
Mailing Address - Phone:908-276-4567
Mailing Address - Fax:908-272-5172
Practice Address - Street 1:1457 RARITAN RD
Practice Address - Street 2:SUITE 101
Practice Address - City:CLARK
Practice Address - State:NJ
Practice Address - Zip Code:07066-1252
Practice Address - Country:US
Practice Address - Phone:908-276-4567
Practice Address - Fax:908-272-5172
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJDI164911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice