Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 18403 | TX |
N | 122300000X | Dentist | 5983 | KY |
N | 1223D0001X | Dental Public Health | 18403 | TX |
NPI | 1457494809 |
---|---|
Provider Name | Dr. Matthew Alan Williams |
First Address | San Antonio, TX 78249-3334 |
Second Address | San Antonio, TX 78229-4507 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2007 |
Last Update Date | 08/07/2007 |