Individual
DR. KENNETH BYRON WILLEFORD
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
128 ROSS ST, MOLALLA, OR 97038-9390
(503) 829-7677
Mailing address
PO BOX 305, MOLALLA, OR 97038-0305
(503) 829-7677
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5531
OR
Other
Enumeration date
07/22/2005
Last updated
07/08/2007
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