Organization
WILLIS 1 DENTISTRY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAUN WILLIS DMD (OWNER)
(979) 541-5400
Entity
Organization
Contact information
Practice address
1108 N MECHANIC ST, EL CAMPO, TX 77437-3030
(979) 541-5400
Mailing address
1108 N MECHANIC ST, EL CAMPO, TX 77437-3030
(979) 541-5400
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
27076
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27076
STATE LICENSE
TX
Enumeration date
08/22/2016
Last updated
06/16/2025
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