| Mark a Willis DDS MS PA | |
|
5604 Ellsworth Rd Fort Smith AR 72903 | |
| (479) 484-7336 | |
| (479) 484-8128 |
| Full Name | Mark a Willis DDS MS PA |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 5604 Ellsworth Rd, Fort Smith, Arkansas |
| Authorized Official Name and Position | Mark a Willis (OWNER) |
| Authorized Official Contact | 4794847336 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark a Willis DDS MS PA 5604 Ellsworth Rd Fort Smith AR 72903 Ph: (479) 484-7336 | Mark a Willis DDS MS PA 5604 Ellsworth Rd Fort Smith AR 72903 Ph: (479) 484-7336 |
| NPI Number | 1932281805 |
|---|---|
| Provider Enumeration Date | 10/20/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932281805 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | () | Primary |
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