Individual
COURTNEY WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1109 14TH ST S, NAMPA, ID 83651-2772
(208) 899-8208
Mailing address
1109 14TH ST S, NAMPA, ID 83651-2772
(208) 899-8208
(208) 899-8203
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D-5273
ID
1223G0001X
General Practice Dentistry
Primary
D5273
ID
Other
Enumeration date
06/22/2021
Last updated
05/29/2026
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