Individual
DR. THEODORE ALBERT MCWILLIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
4660 S EASTERN AVE, SUITE 103, LAS VEGAS, NV 89119-6137
(702) 456-0005
Mailing address
4660 S EASTERN AVE, SUITE 103, LAS VEGAS, NV 89119-6137
(702) 456-0005
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2103
NV
Other
Enumeration date
09/19/2007
Last updated
09/19/2007
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