Individual
DR. JON R WILLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1903 WILMINGTON DR UNIT 101, FORT COLLINS, CO 80528-6100
(970) 568-5255
Mailing address
1903 WILMINGTON DR UNIT 101, FORT COLLINS, CO 80528-6100
(970) 568-5255
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
00203801
CO
1223E0200X
Endodontics
1517
WY
390200000X
Student in an Organized Health Care Education/Training Program
2013042229
MO
390200000X
Student in an Organized Health Care Education/Training Program
DEN.00203801
CO
Other
Enumeration date
10/26/2011
Last updated
12/11/2019
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