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Organization
WILLIAMS DENTAL ASSOCIATES NORTH
Active
Organization
WILLIAMS DENTAL ASSOCIATES NORTH
Active
Other names
knox park dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES IVAN WILLIAMS SR. DDS (DENTIST/OWNER)
(214) 265-7771
Entity
Organization
Contact information
Practice address
3001 KNOX ST, SUITE 300, DALLAS, TX 75205-5584
(214) 265-7771
(214) 219-1098
Mailing address
PO BOX 462, FERRIS, TX 75125-0462
(972) 842-5707
(972) 842-5324
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8495
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
296003
UNITED HEALTHCARE
TX
01
—
865491
UNITED CONCORDIA
TX
01
—
96DL
BLUE CROSS BLUE SHIELD
TX
Enumeration date
10/03/2006
Last updated
08/22/2020
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