Organization
WILLIAMS FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRACY LEE WILLIAMS DMD (OWNER)
(601) 319-1918
Entity
Organization
Contact information
Practice address
3223 AUDUBON DR, LAUREL, MS 39440-1422
(601) 319-1918
Mailing address
3223 AUDUBON DR, LAUREL, MS 39440-1422
(601) 319-1918
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
MS 3469-08
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01925741
—
MS
Enumeration date
02/18/2013
Last updated
02/18/2013
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