Organization
BENJAMIN D WILLIAMS DENTAL GROUP LLC
Active
Other names
Shannon R Thomas DMD
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN D WILLIAMS DMD (OWNER)
(256) 231-0077
Entity
Organization
Contact information
Practice address
1715 GOLDEN SPRINGS ROAD, ANNISTON, AL 36207
(256) 231-0077
(256) 231-0866
Mailing address
1715 GOLDEN SPRINGS ROAD, ANNISTON, AL 36207
(256) 231-0077
(256) 231-0866
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
AL4736
AL
261QD0000X
Dental Clinic/Center
4736
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
510-10222
BLUE CROSS BLUE SHIELD OF AL
AL
Enumeration date
08/28/2008
Last updated
06/07/2019
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