Dr. Jeffrey Alan Willis, DDS, MS
Dentist, Prosthodontics in San Diego, CA. Individual provider (NPI-1).
NPI number1164040044
StatusActive
Last updated in NPPESNov 4, 2025
Details
- NPI
- 1164040044
- Entity type
- Individual (NPI-1)
- Name
- Dr. Jeffrey Alan Willis
- Credential
- DDS, MS
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 8, 2020
- Certification date
- Nov 4, 2025
- Last updated
- Nov 4, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223P0700X | Dentist, Prosthodontics | 1188483 | NY | Yes |
Practice location
2310 Craven StSan Diego, CA 92136-5596
Phone 619-556-9095
Mailing address
2310 Craven StSan Diego, CA 92136-5596
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