# MR. MICHAEL S WILLIS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1912917238
- **Gender:** Man
- **Credential:** D.M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 9672 | TN | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | DN011177 | FL | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | DN11177 | FL | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | DS9672 | TN | Yes |

## Other

- **Enumeration date:** 08/09/2006
- **Last updated:** 10/27/2016