Provider Demographics
NPI:1972964195
Name:WILLIAMS, BRITTANY HOWELL (DMD)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:HOWELL
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:AMBER
Other - Last Name:HOWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 4185
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72702-4185
Mailing Address - Country:US
Mailing Address - Phone:479-717-1171
Mailing Address - Fax:479-582-2840
Practice Address - Street 1:3996 N FRONTAGE RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-5122
Practice Address - Country:US
Practice Address - Phone:479-582-3000
Practice Address - Fax:479-582-2840
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-15
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR44091223S0112X, 204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200925400AMedicaid
AR243890679Medicaid