Provider Demographics
NPI:1730152851
Name:WILLIAMS, ALDRED VINCENT (DDS)
Entity type:Individual
Prefix:DR
First Name:ALDRED
Middle Name:VINCENT
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:ALDRED
Other - Middle Name:VINCENT
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:415 N GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81003-3111
Mailing Address - Country:US
Mailing Address - Phone:719-546-3333
Mailing Address - Fax:
Practice Address - Street 1:3401 GEORGIA AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2501
Practice Address - Country:US
Practice Address - Phone:202-829-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD75741223G0001X
VA04014116071223G0001X
DCDEN10005851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice