Individual
DR. JACOB WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1100 N SAN FRANCISCO ST, SUITE D, FLAGSTAFF, AZ 86001-3260
(928) 774-5050
Mailing address
4141 W THORNTON RD, SHOW LOW, AZ 85901-3004
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D009381
AZ
1223G0001X
General Practice Dentistry
DD4156
NM
Other
Enumeration date
10/23/2014
Last updated
10/20/2016
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