Provider Demographics
NPI:1750198438
Name:WILLIAMS, EMILY EVANS (RDH)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:EVANS
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 WEST 6TH STREET
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FORT STEWART
Mailing Address - State:GA
Mailing Address - Zip Code:31314-4704
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:351 WEST 6TH STREET
Practice Address - Street 2:SUITE 100
Practice Address - City:FORT STEWART
Practice Address - State:GA
Practice Address - Zip Code:31314-4704
Practice Address - Country:US
Practice Address - Phone:912-435-5826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-16
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADH011509124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist