Provider Demographics
NPI:1922231125
Name:WILLIAMS, RICHARD OKYERE (DMD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:OKYERE
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 1:2801 KENNEDY ST
Mailing Address - Street 2:
Mailing Address - City:PALATKA
Mailing Address - State:FL
Mailing Address - Zip Code:32177-4109
Mailing Address - Country:US
Mailing Address - Phone:386-326-3200
Mailing Address - Fax:
Practice Address - Street 1:2801 KENNEDY ST
Practice Address - Street 2:
Practice Address - City:PALATKA
Practice Address - State:FL
Practice Address - Zip Code:32177-4109
Practice Address - Country:US
Practice Address - Phone:386-326-3200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-03
Last Update Date:2012-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0139531223G0001X
FLDN186621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice