Provider Demographics
NPI:1932354693
Name:WILLIAMS, ROBERT G (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:G
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 1:555 LAKEHURST RD
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-8044
Mailing Address - Country:US
Mailing Address - Phone:732-341-6800
Mailing Address - Fax:732-341-2112
Practice Address - Street 1:555 LAKEHURST RD
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-8044
Practice Address - Country:US
Practice Address - Phone:732-341-6800
Practice Address - Fax:732-341-2112
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-22
Last Update Date:2008-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ82391223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics