Individual
TERRY CHARLES WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D D S
Contact information
Practice address
17008 E 45TH ST S, INDEPENDENCE, MO 64055-7630
(816) 590-2987
Mailing address
17008 E 45TH ST S, INDEPENDENCE, MO 64055-7630
(816) 590-2987
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10173
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1992786412
UMKC SCHOOL OF DENTISTRY
MO
Enumeration date
04/17/2015
Last updated
04/17/2015
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