Individual
DR. WARREN RICHARD WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
119 N WARDWELL AVE, EMMETT, ID 83617-3040
(208) 365-6313
(208) 365-1303
Mailing address
119 N WARDWELL AVE, EMMETT, ID 83617-3040
(208) 365-6313
(208) 365-1303
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D3635
ID
Other
Enumeration date
11/15/2006
Last updated
07/08/2007
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