Wellpoint Dental

NPI #1194980417 in Meridian, Idaho

Provider Information

NPI Number: 1194980417
Entity Type: Organization
Organization Name: Wellpoint Dental
Primary Specialty: Dentist - General Practice
Enumeration Date: Jul 25, 2008
Last Updated: Jul 25, 2008

Practice Location

Address: 2700 W CHERRY LN
City: Meridian
State: Idaho
ZIP Code: 83642-1137
Phone: (208) 887-9000

Authorized Official

Name: DR. WARREN R WILLIS, DMD
Title: CO-OWNER
Phone: (208) 887-9000

Specialties & Taxonomy Codes

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

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