Provider Demographics
NPI:1902814155
Name:WILLIAMS, BOB H (DDS)
Entity Type:Individual
Prefix:
First Name:BOB
Middle Name:H
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5726 100TH ST SW
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-2730
Mailing Address - Country:US
Mailing Address - Phone:253-272-2900
Mailing Address - Fax:253-404-0684
Practice Address - Street 1:2315 N 30TH ST
Practice Address - Street 2:SUITE 202
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98403-3322
Practice Address - Country:US
Practice Address - Phone:253-272-2900
Practice Address - Fax:253-404-0684
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2017-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA4701122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist