DR. Theodore Albert Mcwillie, D.D.S.

NPI #1083800429 in Las Vegas, Nevada

Provider Information

NPI Number: 1083800429
Entity Type: Individual
Name: DR. Theodore Albert Mcwillie, D.D.S.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist - General Practice
Credential: D.D.S.
Enumeration Date: Sep 19, 2007
Last Updated: Sep 19, 2007

Practice Location

Address: 4660 S EASTERN AVE
Address 2: SUITE 103
City: Las Vegas
State: Nevada
ZIP Code: 89119-6137
Phone: (702) 456-0005

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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