Provider Demographics
NPI:1356548960
Name:WILLIAMS, TODD PATRICK (DMD)
Entity type:Individual
Prefix:DR
First Name:TODD
Middle Name:PATRICK
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10399 PARADISE BLVD
Mailing Address - Street 2:#205
Mailing Address - City:TREASURE ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33706-3149
Mailing Address - Country:US
Mailing Address - Phone:727-771-3980
Mailing Address - Fax:
Practice Address - Street 1:2700 E BAY DR
Practice Address - Street 2:SUITE 204
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33771-2468
Practice Address - Country:US
Practice Address - Phone:727-536-3400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN171881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice