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Dr. Mark A Willis, DDS,MS,PA
Pediatric Dentist in Watkinsville, Georgia
NPI 1326136326

Mark A Willis is a Pediatric Dentist based in Grayson, GA and is specialized in Pediatric Dentistry. Mark A Willis practices in Watkinsville, GA and has the professional credentials of DDS,MS,PA. The NPI Number for Mark A Willis is 1326136326 and holds a License No. 2634 (Georgia).

The current practice location address for Mark A Willis is 1795 Resurgence Dr, Watkinsville, GA and can be reached out via phone at 479-692-1392 and via fax at 770-982-0005.

Location: 1795 Resurgence Dr, Watkinsville, GA, 30017-1084
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1326136326
Provider Name
Mark A Willis
Credential
DDS,MS,PA
Provider Entity Type
Individual
Gender
Male
Address
1795 Resurgence Dr, Watkinsville, GA, 30017-1084
Phone Number
479-692-1392
Fax Number
770-982-0005
Provider Enumeration Date
10/11/2006
Last Update Date
07/20/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
100140260A 05 OK
institution
Provider Business Practice Location Address Details
Address
1795 Resurgence Dr
City
Watkinsville
State
Georgia
Zip
30677-7306
Phone Number
479-692-1392
Fax Number
770-982-0005
person
Provider Business Mailing Address Details
Address
1795 Resurgence Dr
City
Watkinsville
State
Georgia
Zip
30677-7306
Phone Number
479-692-1392
Fax Number
770-982-0005
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
2634 (Arkansas)
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
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