Individual
DR. DEAN NORMAN WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
50 FAIR HARBOUR PL, SUITE 2-C, NEW LONDON, CT 06320-4731
(860) 443-3147
(860) 443-0087
Mailing address
50 FAIR HARBOUR PL, SUITE 2-C, NEW LONDON, CT 06320-4731
(860) 443-3147
(860) 443-0087
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
22374
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001223742
—
CT
Enumeration date
10/03/2006
Last updated
02/03/2010
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