Individual
RANDALL EDWARD WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
800 WALL ST, SUITE C, VALPARAISO, IN 46383-2564
(219) 531-0459
(219) 464-9656
Mailing address
800 WALL ST, SUITE C, VALPARAISO, IN 46383-2564
(219) 531-0459
(219) 464-9656
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12009730
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
799250
UNITED CONCORDIA INS
—
Enumeration date
11/20/2006
Last updated
07/08/2007
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