Provider Demographics
NPI:1336390848
Name:WILLIAMS, MONICA N (DDS)
Entity Type:Individual
Prefix:DR
First Name:MONICA
Middle Name:N
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 1:2000 S UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72204-3600
Mailing Address - Country:US
Mailing Address - Phone:501-588-7406
Mailing Address - Fax:
Practice Address - Street 1:2000 S UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72204-3600
Practice Address - Country:US
Practice Address - Phone:501-688-7406
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-02
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR36941223G0001X, 1223D0001X
GADN0140591223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001051600Medicaid
AR188373608Medicaid