Individual
DR. TYJUAN MARCQUELL WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
4045 JIMMIE DYESS PKWY, SUITE 103, AUGUSTA, GA 30909-9491
(706) 868-4200
(706) 868-4717
Mailing address
4045 JIMMIE DYESS PKWY, SUITE 103, AUGUSTA, GA 30909-9491
(706) 868-4200
(706) 868-4717
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN013725
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003107901B
—
GA
Enumeration date
06/27/2008
Last updated
10/31/2013
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