Individual
DR. BRIAN JEREMY WILLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
204 STATE ST, PETOSKEY, MI 49770-2718
(231) 347-8980
Mailing address
204 STATE ST, PETOSKEY, MI 49770-2718
(231) 347-8980
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901010974
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4037439
—
MI
Enumeration date
09/25/2006
Last updated
07/09/2007
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