Individual
DR. MATTHEW W WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD, MA
Contact information
Practice address
98-1005 MOANALUA RD SPC 2000, AIEA, HI 96701-4700
(808) 489-9530
Mailing address
19805 N 63RD DR, GLENDALE, AZ 85308-6901
(480) 721-5943
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DT-3173
HI
Other
Enumeration date
06/13/2024
Last updated
06/13/2024
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