Individual
DR. JOHN R WILLOUGHBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, PHD
Contact information
Practice address
4326 GEORGE WASHINGTON HIGHWAY, YORKTOWN, VA 23692-2707
(540) 867-0174
Mailing address
4326 GEORGE WASHINGTON HIGHWAY, YORKTOWN, VA 23692-2707
(540) 867-0174
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401412434
VA
1223G0001X
General Practice Dentistry
049-23517
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0401412434
DENTAL LICENSE # --- VIRGINIA
VA
Enumeration date
08/20/2008
Last updated
01/12/2010
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