Organization
WARREN WILLIS DMD P.C.
Active
Other names
Emmett Dental Group P.C.
Organization subpart
No
Provider details
NPI number
Authorized official
WARREN RICHARD WILLIS DMD (OWNER)
(208) 365-6313
Entity
Organization
Contact information
Practice address
119 N WARDWELL AVE, EMMETT, ID 83617-3040
(208) 365-6313
Mailing address
119 N WARDWELL AVE, EMMETT, ID 83617-3040
(208) 365-6313
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-3635
ID
Other
Enumeration date
12/17/2008
Last updated
12/17/2008
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