Provider Demographics
NPI:1952816720
Name:WILLIAMS, JESSICA KAREN (DMD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:KAREN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:696 PYTHON DR
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30349-7659
Mailing Address - Country:US
Mailing Address - Phone:404-401-9704
Mailing Address - Fax:
Practice Address - Street 1:212 VILLAGE CENTER PKWY STE 212
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-9044
Practice Address - Country:US
Practice Address - Phone:770-506-2443
Practice Address - Fax:770-506-2497
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-02
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN015549122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist