Organization
DR. SALLY R. WILLIS, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SALLY R. WILLIS DMD (PRESIDENT)
(502) 231-9970
Entity
Organization
Contact information
Practice address
7600 OUTER LOOP, LOUISVILLE, KY 40228-1729
(502) 231-9970
(502) 231-9972
Mailing address
7600 OUTER LOOP, LOUISVILLE, KY 40228-1729
(502) 231-9970
(502) 231-9972
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5032
KY
Other
Enumeration date
11/22/2006
Last updated
08/22/2020
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