Provider Demographics
NPI:1780996843
Name:WILLIAMS, LAURA B (DMD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:B
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 1:1110 BEECHER XING N
Mailing Address - Street 2:STE A
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-4564
Mailing Address - Country:US
Mailing Address - Phone:614-775-1300
Mailing Address - Fax:
Practice Address - Street 1:1110 BEECHER XING N
Practice Address - Street 2:STE A
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-4564
Practice Address - Country:US
Practice Address - Phone:614-775-1300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-06
Last Update Date:2016-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-023161122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist