Organization
MARK A WILLIS DDS MS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK A WILLIS (OWNER)
(479) 484-7336
Entity
Organization
Contact information
Practice address
5604 ELLSWORTH RD, FORT SMITH, AR 72903
(479) 484-7336
(479) 484-8128
Mailing address
5604 ELLSWORTH RD, FORT SMITH, AR 72903
(479) 484-7336
(479) 484-8128
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
10/20/2006
Last updated
08/22/2020
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