Alexis Lauren Willis, DMD
Dentist in Cairo, GA. Individual provider (NPI-1).
NPI number1295564656
StatusActive
Last updated in NPPESAug 1, 2024
Details
- NPI
- 1295564656
- Entity type
- Individual (NPI-1)
- Name
- Alexis Lauren Willis
- Credential
- DMD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 1, 2024
- Certification date
- Jul 10, 2024
- Last updated
- Aug 1, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | DN123542 | GA | Yes |
Practice location
718 N Broad StCairo, GA 39828-1607
Phone 229-377-4204
Mailing address
718 N Broad StCairo, GA 39828-1607
Phone 229-377-4204
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