| Willow Dental | |
|
1367 Highway 72 Killen AL 35645-9136 | |
| (256) 757-5313 | |
| Not Available |
| Full Name | Willow Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1367 Highway 72, Killen, Alabama |
| Authorized Official Name and Position | Stacey L Evans (MANAGER) |
| Authorized Official Contact | 2568103955 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Willow Dental 515 County Road 402 Killen AL 35645-5815 Ph: (256) 810-3955 | Willow Dental 1367 Highway 72 Killen AL 35645-9136 Ph: (256) 757-5313 |
| NPI Number | 1851936942 |
|---|---|
| Provider Enumeration Date | 11/12/2019 |
| Last Update Date | 11/12/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851936942 | NPI | - | NPPES |
| 1003969312 | Other | AL | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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