Individual
DR. VINCENT L WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD,PA
Contact information
Practice address
590 FALLS AVE, TWIN FALLS, ID 83301-3314
(208) 734-3562
(208) 736-8339
Mailing address
590 FALLS AVE, TWIN FALLS, ID 83301-3314
(208) 734-3562
(208) 736-8339
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D1658-OS
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001226500
—
ID
05
—
001226600
—
ID
05
—
805148000
—
ID
Enumeration date
02/12/2007
Last updated
11/28/2011
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