Individual
ALEXIS LAUREN WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
718 N BROAD ST, CAIRO, GA 39828-1607
(229) 377-4204
Mailing address
718 N BROAD ST, CAIRO, GA 39828-1607
(229) 377-4204
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN123542
GA
Other
Enumeration date
08/01/2024
Last updated
08/01/2024
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