Individual
DR. MICHAEL GLEN WILLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
740 OAK AVE, SUITE A, CARLSBAD, CA 92008-2455
(760) 434-5031
Mailing address
740 OAK AVE, SUITE A, CARLSBAD, CA 92008-2455
(760) 434-5031
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
42448
CA
Other
Enumeration date
09/06/2006
Last updated
07/08/2007
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