Individual provider · Type 1 NPI
Dale Wayne Willoughby, DDS
Oral and Maxillofacial Surgery (Dentist) · Kenosha, WI
NPI number
1700880556
Active
Practice location
6707 39th Ave
Kenosha, WI 53142-7125
Fax (262) 658-0276
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) Primary | 1223S0112X | 4998-015 (WI) |
Oral and Maxillofacial Surgery (Dentist): 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.
Another provider at this address
Other oral and maxillofacial surgery (dentist) providers in Kenosha
About NPI 1700880556
Dale Wayne Willoughby, DDS's National Provider Identifier is 1700880556, issued on Jun 9, 2005. The primary taxonomy on file is Oral and Maxillofacial Surgery (Dentist) (1223S0112X), and the practice location is in Kenosha, WI. The record was last updated on Jun 2, 2022.