Warren Willis Dmd P.c.

NPI #1255577490 in Emmett, Idaho

Provider Information

NPI Number: 1255577490
Entity Type: Organization
Organization Name: Warren Willis Dmd P.c.
Primary Specialty: Dentist - General Practice
Enumeration Date: Dec 17, 2008
Last Updated: Dec 17, 2008

Practice Location

Address: 119 N WARDWELL AVE
City: Emmett
State: Idaho
ZIP Code: 83617-3040
Phone: (208) 365-6313

Authorized Official

Name: WARREN RICHARD WILLIS, DMD
Title: OWNER
Phone: (208) 365-6313

Specialties & Taxonomy Codes

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

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