Individual
DR. WESTON ALEXANDER WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS MSC O
Contact information
Practice address
17 OFFICE PARK DR, JACKSONVILLE, NC 28546-3219
(910) 353-5234
(910) 353-1999
Mailing address
531 DEER CREEK DRIVE, CAPE CARTERET, NC 28584
(252) 393-8344
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
2846
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8999384
—
NC
01
—
99384
BLUE CROSS BLUE SHIELD NC
NC
Enumeration date
09/11/2006
Last updated
03/24/2011
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