Individual
CLARENCE WILLIAMS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
275 SOUTH MAIN STREET, WAGENER, SC 29164
(803) 564-6582
(803) 564-6584
Mailing address
PO BOX 205, 275 SOUTH MAIN STREET, WAGENER, SC 29164-0205
(803) 564-6582
(803) 564-6584
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
SC3240
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Z32402
—
SC
Enumeration date
10/10/2006
Last updated
07/08/2007
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