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1700880556
DALE WAYNE WILLOUGHBY
KENOSHA, WI
NPI
1700880556
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223S0112X Dentist, Oral and Maxillofacial Surgery
(Licence: WI 4998-015)
Enumeration Date
2005-06-09
Last Update Date
2022-06-02
Business Address
DALE WAYNE WILLOUGHBY DDS
6707 39TH AVE
KENOSHA, WI 53142-7125
Phone number: 262-658-3559
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Mailing Address
DALE WAYNE WILLOUGHBY DDS
6707 39TH AVE
KENOSHA, WI 53142-7125
Phone number: 262-658-3559
Copy
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