Provider Demographics
NPI:1902943525
Name:WILLIAMS & TATE LLC
Entity Type:Organization
Organization Name:WILLIAMS & TATE LLC
Other - Org Name:EAST EARL FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR. OFFICE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:MAE
Authorized Official - Middle Name:
Authorized Official - Last Name:HIGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-354-7904
Mailing Address - Street 1:1254 E. EARL RD
Mailing Address - Street 2:
Mailing Address - City:EAST EARL
Mailing Address - State:PA
Mailing Address - Zip Code:17519
Mailing Address - Country:US
Mailing Address - Phone:717-354-7904
Mailing Address - Fax:717-354-0754
Practice Address - Street 1:1254 E. EARL RD
Practice Address - Street 2:
Practice Address - City:EAST EARL
Practice Address - State:PA
Practice Address - Zip Code:17519
Practice Address - Country:US
Practice Address - Phone:717-354-7904
Practice Address - Fax:717-354-0754
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS030800R122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty