Individual
DR. COLE WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4450 BLUEBONNET BLVD, SUITE B, BATON ROUGE, LA 70809-9648
(225) 927-5246
(225) 927-1788
Mailing address
1518 PICKETT AVE, BATON ROUGE, LA 70808-3848
(225) 252-7367
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6081
LA
Other
Enumeration date
06/23/2010
Last updated
06/23/2010
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