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Contact Information

WILLIAMS ORAL AND MAXILLOFACIAL SURGERY
330 E STUMER RD
RAPID CITY, SD57701-6406
 Phone: 605-348-3400
 Fax: 605-348-1626
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Oral and Maxillofacial Surgery

261QS0112X
Indicates primary specialty

NPI Profile & details for WILLIAMS ORAL AND MAXILLOFACIAL SURGERY

NPI Number 1659543973
LBN Legal business name WILLIAMS ORAL AND MAXILLOFACIAL SURGERY
Authorized official GREGORY WILLIAMS - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 03/26/2008
Last updated 03/26/2008 - About 18 years ago
Identifiers
SD License # M808
SD Medicaid 8000390
Other 0003519 BLUE CROSS BLUE SHIELD
Other 690846 UNITED CONCORDIA
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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