Provider Demographics
NPI:1740472521
Name:WILLIAMS, BRISTOL MARIE (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:BRISTOL
Middle Name:MARIE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7878 ROSWELL RD
Mailing Address - Street 2:STE. O
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30350-6880
Mailing Address - Country:US
Mailing Address - Phone:678-443-1491
Mailing Address - Fax:678-443-1441
Practice Address - Street 1:7878 ROSWELL RD
Practice Address - Street 2:STE. O
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30350-6880
Practice Address - Country:US
Practice Address - Phone:678-443-1491
Practice Address - Fax:678-443-1441
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-15
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0133631223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics