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Individual

ALBERT WILLIS II

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.M.D., M.D.

Contact information

Practice address
540 HUGHES RD, SUITE 6, MADISON, AL 35758-8999
(256) 464-7873
(256) 464-7864
Mailing address
540 HUGHES RD, SUITE 6, MADISON, AL 35758-8999
(256) 464-7873
(256) 464-7864

Taxonomy

Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
16039
AL

Other

Enumeration date
09/02/2014
Last updated
09/02/2014
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