Individual
DR. BRYAN JACK WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DE00007285
WA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
DE00007285
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0130118
—
MT
05
—
03556700
—
ID
05
—
5100011
—
WA
05
—
DD103WA
—
AK
Enumeration date
09/14/2006
Last updated
01/29/2018
Update your record
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