Individual
KAILAH MARIE WILLMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
4111 W 6TH ST, LAWRENCE, KS 66049-4609
(319) 961-5065
Mailing address
1115 BRYNWOOD CT, LAWRENCE, KS 66049-7505
(319) 961-5065
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
61683
KS
Other
Enumeration date
07/29/2020
Last updated
07/29/2020
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