Individual
AUSTIN CLAY WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
1301 WINCHESTER RD, LEXINGTON, KY 40505-4153
(859) 785-4352
Mailing address
2475 TIPTON RD, MT STERLING, KY 40353-9307
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
11342
KY
1223G0001X
General Practice Dentistry
Primary
11342
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/12/2025
Last updated
05/21/2025
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