Provider Demographics
NPI:1780181412
Name:WILLIAMS, DONIELLE FA'NICE (DMD)
Entity type:Individual
Prefix:DR
First Name:DONIELLE
Middle Name:FA'NICE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3921 OBRYANT CIR SE
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30082-3906
Mailing Address - Country:US
Mailing Address - Phone:404-512-1889
Mailing Address - Fax:
Practice Address - Street 1:4920 ROSWELL RD STE 265
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-2686
Practice Address - Country:US
Practice Address - Phone:404-458-9908
Practice Address - Fax:404-458-9905
Is Sole Proprietor?:No
Enumeration Date:2018-04-09
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0157121223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry