Individual
DR. LAWRENCE M WILLIS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
6537 E 72ND PL, COMMERCE CITY, CO 80022-1704
(303) 288-7020
Mailing address
6537 E 72ND PL, COMMERCE CITY, CO 80022-1704
(303) 288-7020
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
104956
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02049567
—
CO
Enumeration date
04/23/2007
Last updated
07/08/2007
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