Provider Demographics
NPI:1639265887
Name:WILLIAMS, GEORGE CARROLL (DDS)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:CARROLL
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 1:5 RUXTON GREEN COURT
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-3548
Mailing Address - Country:US
Mailing Address - Phone:410-825-3450
Mailing Address - Fax:410-659-0902
Practice Address - Street 1:600 LIGHT ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21230-3856
Practice Address - Country:US
Practice Address - Phone:410-659-0900
Practice Address - Fax:410-659-0902
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDMD067341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice