Individual
TERRY A WILLIS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
127 HUNTS BRIDGE RD, GREENVILLE, SC 29617-1623
(864) 246-6471
(864) 246-9917
Mailing address
127 HUNTS BRIDGE RD, GREENVILLE, SC 29617-1623
(864) 246-6471
(864) 246-9917
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2219
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Z22191
—
SC
Enumeration date
12/15/2005
Last updated
07/08/2007
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