Provider Demographics
NPI:1952597882
Name:J. LADD WILLIAMS, D.D.S.
Entity type:Organization
Organization Name:J. LADD WILLIAMS, D.D.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:J.
Authorized Official - Middle Name:LADD
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:480-964-9020
Mailing Address - Street 1:1244 N GREENFIELD RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85205-4077
Mailing Address - Country:US
Mailing Address - Phone:480-964-9020
Mailing Address - Fax:480-924-4545
Practice Address - Street 1:1244 N GREENFIELD RD
Practice Address - Street 2:SUITE 103
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85205-4077
Practice Address - Country:US
Practice Address - Phone:480-964-9020
Practice Address - Fax:480-924-4545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-25
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAZ4465261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental