Organization
GRAND AVE DENTAL CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE W. WILLIAMS III DDS (MEMBER)
(405) 224-1311
Entity
Organization
Contact information
Practice address
720 W GRAND AVE, CHICKASHA, OK 73018-5743
(405) 224-1311
(405) 222-3654
Mailing address
720 W GRAND AVE, CHICKASHA, OK 73018-5743
(405) 224-1311
(405) 222-3654
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3609
OK
1223G0001X
General Practice Dentistry
5709
OK
1223G0001X
General Practice Dentistry
6126
OK
Other
Enumeration date
07/01/2010
Last updated
07/01/2010
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