Individual
DR. HENRY SK WILLIS IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
6811 MAIN ST, SUITE A, BONNERS FERRY, ID 83805-8649
(208) 267-6454
Mailing address
6811 MAIN ST, SUITE A, BONNERS FERRY, ID 83805-8649
(208) 267-6454
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-3784
ID
Other
Enumeration date
10/31/2005
Last updated
07/12/2007
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