Provider Demographics
NPI:1134173164
Name:WILLIAMS, DENT (MD)
Entity type:Individual
Prefix:
First Name:DENT
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7040A SYDNEY CURV
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-3508
Mailing Address - Country:US
Mailing Address - Phone:334-409-9550
Mailing Address - Fax:334-386-0195
Practice Address - Street 1:7040A SYDNEY CURV
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-3508
Practice Address - Country:US
Practice Address - Phone:334-409-9550
Practice Address - Fax:334-386-0195
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5977207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALP00197813OtherRAILROAD MEDICARE
AL009937185Medicaid
ALDC9103OtherRAILROAD GROUP
AL051518370OtherBCBS
ALC75092Medicare UPIN
AL051518370Medicare PIN
AL051518370OtherBCBS