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Individual

LARRY S WILLIAMS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
115 BUSINESS LOOP 70 W, COLUMBIA, MO 65203-3244
(573) 884-6253
(573) 884-5390
Mailing address
PO BOX 7687, COLUMBIA, MO 65205-7687
(573) 882-2259

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DE011674
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
400904629
MO
Enumeration date
06/01/2006
Last updated
09/25/2008
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