Provider Demographics
NPI:1831592294
Name:WILLIAMS, CORY JAY (DMD)
Entity type:Individual
Prefix:DR
First Name:CORY
Middle Name:JAY
Last Name:WILLIAMS
Suffix:
Gender:M
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:PO BOX 339
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:81602-0339
Mailing Address - Country:US
Mailing Address - Phone:970-928-1635
Mailing Address - Fax:
Practice Address - Street 1:410 MCGREGOR DRIVE
Practice Address - Street 2:
Practice Address - City:GYPSUM
Practice Address - State:CO
Practice Address - Zip Code:81637
Practice Address - Country:US
Practice Address - Phone:970-945-2840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-30
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO00202165122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist