| Willis Family Dentistry | |
|
5335 Broadway Blvd Ste 209 Garland TX 75043-7099 | |
| (972) 240-7585 | |
| (972) 303-6109 |
| Full Name | Willis Family Dentistry |
|---|---|
| Speciality | Dentist |
| Location | 5335 Broadway Blvd Ste 209, Garland, Texas |
| Authorized Official Name and Position | Schrie Willis (DENTIST/OWNER) |
| Authorized Official Contact | 9722407585 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Willis Family Dentistry 5335 Broadway Blvd Ste 209 Garland TX 75043-7099 Ph: (972) 240-7585 | Willis Family Dentistry 5335 Broadway Blvd Ste 209 Garland TX 75043-7099 Ph: (972) 240-7585 |
| NPI Number | 1417298365 |
|---|---|
| Provider Enumeration Date | 03/01/2013 |
| Last Update Date | 07/07/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417298365 | NPI | - | NPPES |
| 216234901 | Medicaid | TX | |
| 216234925 | Medicaid | TX | |
| 216234924 | Medicaid | TX | |
| 216234926 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 24191 (Texas) | Primary |
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