Individual
DR. DAVID MARK WILLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
30014345
OH
1223G0001X
General Practice Dentistry
014345
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34-1910479
TAX ID
—
Enumeration date
12/12/2006
Last updated
09/21/2016
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