Dale Wayne Willoughby, DDS

NPI #1700880556 in Kenosha, Wisconsin

Provider Information

NPI Number
1700880556
Entity Type
Individual
Name
Dale Wayne Willoughby, DDS
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Dentist - Oral and Maxillofacial Surgery
Credential
DDS
Enumeration Date
Jun 9, 2005
Last Updated
Jun 2, 2022

Practice Location

Address
6707 39TH AVE
ZIP Code
53142-7125
Phone
(262) 658-3559

Specialties & Taxonomy Codes

Specialty
Dentist - Oral and Maxillofacial SurgeryOral and Maxillofacial Surgery

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Organizations

Provider Name
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