Individual
DR. THOMAS T. WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2691 SANDLIN RD SW STE C, DECATUR, AL 35601-7362
(256) 350-4616
(256) 350-4819
Mailing address
2691 SANDLIN RD SW STE C, DECATUR, AL 35601-7362
(256) 350-4616
(256) 350-4819
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3373
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
537865
UNITED CONCORDIA
AL
01
—
97608
BCBS OF AL
AL
Enumeration date
03/12/2007
Last updated
07/08/2007
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