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Organization
WARREN WILLIS DMD P.C.
Active
Organization
WARREN WILLIS DMD P.C.
Active
Other names
Emmett Dental Group P.C.
Organization subpart
No
Provider details
NPI number
Authorized official
WARREN RICHARD WILLIS DMD (OWNER)
(208) 365-6313
Entity
Organization
Contact information
Practice address
119 N WARDWELL AVE, EMMETT, ID 83617-3040
(208) 365-6313
Mailing address
119 N WARDWELL AVE, EMMETT, ID 83617-3040
(208) 365-6313
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-3635
ID
Other
Enumeration date
12/17/2008
Last updated
12/17/2008
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