Dale Wayne Willoughby in Kenosha - Oral And Maxillofacial Surgery
Dale Wayne Willoughby - NPI 1700880556
Dale Wayne Willoughby is a Oral And Maxillofacial Surgery in Kenosha, Wisconsin. Dale Wayne Willoughby practices all healthcare services and medical treatments related to Oral And Maxillofacial Surgery. The NPI Number for Dale Wayne Willoughby is 1700880556. The last update date is 2022-06-02.
Dale Wayne Willoughby's current location address is 6707 39th Ave, Kenosha, Wisconsin. You can contact this provider via phone number 2626583559 and fax number 2626531142. The mailing address for Dale Wayne Willoughby is 6707 39th Ave, Kenosha, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Dale Wayne Willoughby |
|---|---|
| Address | 6707 39th Ave, Kenosha, Wisconsin |
| Phone Number | 2626583559 |
| Fax Number | 2626531142 |
| Sole Proprietor | Y |
| Credentials | DDS |
NPI Number Detail
| NPI Number | 1700880556 |
|---|---|
| Provider Enumeration Date | 2005-06-09 |
| Last Updated Date | 2022-06-02 |
Provider Mailing Address Detail
| Address | 6707 39th Ave |
|---|---|
| City | Kenosha |
| State | Wisconsin (WI) |
| Post Code | 5314271250 |
| Phone Number | 2626583559 |
| Fax Number | 2626531142 |
Provider's Primary Taxonomy Detail
| Speciality | Oral And Maxillofacial Surgery |
|---|---|
| Taxonomy | 1223S0112X |
| Licence No | 4998-015 |
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Definition: The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
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Post Comment/ Review Below
What is the Dale Wayne Willoughby's unique identification number?
The Dale Wayne Willoughby has been assigned the NPI (National Provider Identifier) Number 1700880556 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you please share the complete physical location address where Dale Wayne Willoughby's facilities are situated?
The facilities of Dale Wayne Willoughby are physically located at the following address: 6707 39Th Ave, Kenosha, WI, 5314271250.
What is Dale Wayne Willoughby's area of expertise and its corresponding taxonomy classification?
The Dale Wayne Willoughby's field of specialization is Oral And Maxillofacial Surgery, and it falls under the taxonomy code 1223S0112X, which categorizes healthcare providers based on their areas of practice.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1700880556 to Dale Wayne Willoughby?
The Centers for Medicare & Medicaid Services originally issued the 1700880556 to Dale Wayne Willoughby on 2005-06-09.
As of what date was the information regarding Dale Wayne Willoughby, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Dale Wayne Willoughby, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2022-06-02.