# JAMES W WILLIS XI DDS PLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Northeast Roanoke Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558078857
- **Authorized official:** JAMES WILLIS DDS (CEO)
- **Authorized official phone:** (304) 685-5980

## Contact information

- **Practice address:** 2913 ORANGE AVE NE, ROANOKE, VA 24012-6338
- **Practice address phone:** (540) 342-8781
- **Mailing address:** 6948 WELBOURNE LN, CROZET, VA 22932-3346
- **Mailing address phone:** (304) 685-5980

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 11/04/2022
- **Last updated:** 11/04/2022