Provider Demographics
NPI:1013008853
Name:WILLIAMS, LAURA COX (DDS)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:COX
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:WV
Mailing Address - Zip Code:24740-3626
Mailing Address - Country:US
Mailing Address - Phone:304-487-5605
Mailing Address - Fax:304-487-5610
Practice Address - Street 1:201 LOCUST ST
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:WV
Practice Address - Zip Code:24740-3626
Practice Address - Country:US
Practice Address - Phone:304-487-5605
Practice Address - Fax:304-487-5610
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV3675122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810003005Medicaid