Individual
DR. CHARLES STEADMAN WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1212 BROAD ST, DURHAM, NC 27705-3572
(919) 286-0745
(919) 286-2352
Mailing address
1212 BROAD ST, DURHAM, NC 27705-3572
(919) 286-0745
(919) 286-2352
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3977
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8999377
—
NC
Enumeration date
11/09/2006
Last updated
07/09/2007
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