# WILLOWTREE DENTAL GROUP PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548282528
- **Authorized official:** IRENE D TURNER (OFFICE ADMINISTRATOR)
- **Authorized official phone:** (208) 888-2055

## Contact information

- **Practice address:** 317 W CHERRY LN, MERIDIAN, ID 83642-1608
- **Practice address phone:** (208) 888-2055
- **Practice address fax:** (208) 327-0214
- **Mailing address:** 317 W CHERRY LN, MERIDIAN, ID 83642-1608
- **Mailing address phone:** (208) 888-2055
- **Mailing address fax:** (208) 327-0214

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | D1820 | ID | Yes |

## Other

- **Enumeration date:** 07/25/2006
- **Last updated:** 08/22/2020