Dr. Todd Bradford Willis, DDS
Dentist in Waco, TX. Individual provider (NPI-1).
NPI number1619084662
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1619084662
- Entity type
- Individual (NPI-1)
- Name
- Dr. Todd Bradford Willis
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 24, 2006
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 12163 | TX | Yes |
Practice location
1615 Wooded Acres DriveSuite #f
Waco, TX 76710-2863
Phone 254-776-7242 · Fax 254-776-0696
Mailing address
1615 Wooded Acres Drive#f
Waco, TX 76710-2863
Phone 254-776-7242 · Fax 254-776-0696
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