Provider Demographics
NPI:1912017765
Name:JAMES R WILLIAMS DDS PC
Entity Type:Organization
Organization Name:JAMES R WILLIAMS DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:RAYMOND
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:III
Authorized Official - Credentials:DDS
Authorized Official - Phone:810-686-8460
Mailing Address - Street 1:11610 N SAGINAW ST
Mailing Address - Street 2:
Mailing Address - City:MT MORRIS
Mailing Address - State:MI
Mailing Address - Zip Code:48458
Mailing Address - Country:US
Mailing Address - Phone:810-686-8460
Mailing Address - Fax:810-686-4098
Practice Address - Street 1:11610 N SAGINAW ST
Practice Address - Street 2:
Practice Address - City:MT MORRIS
Practice Address - State:MI
Practice Address - Zip Code:48458
Practice Address - Country:US
Practice Address - Phone:810-686-8460
Practice Address - Fax:810-686-4098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010130131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty