Provider Demographics
NPI:1457439911
Name:WILLIAMS, ROBERT JEFFREY (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JEFFREY
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 PROFESSIONAL DR
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-6410
Mailing Address - Country:US
Mailing Address - Phone:707-252-7733
Mailing Address - Fax:707-252-4639
Practice Address - Street 1:1000 PROFESSIONAL DR
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-6410
Practice Address - Country:US
Practice Address - Phone:707-252-7733
Practice Address - Fax:707-252-4639
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA453401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
1691703OtherUNITED CONCORDIA ID
CA45340OtherDDS LICENSE NUMBER