Provider Demographics
NPI:1447447305
Name:WILLIAMS, JOHN EASON (DDS)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:EASON
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2603 BROWNS LN
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-7227
Mailing Address - Country:US
Mailing Address - Phone:870-935-4060
Mailing Address - Fax:870-931-6715
Practice Address - Street 1:2603 BROWNS LN
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-7227
Practice Address - Country:US
Practice Address - Phone:870-935-4060
Practice Address - Fax:870-931-6715
Is Sole Proprietor?:No
Enumeration Date:2007-09-25
Last Update Date:2013-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS0000004672122300000X
AR3940122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist