Willis, Sheldon

Willis, Sheldon is an individual health care provider with primary practice located at 1000 Lakeland Square Ext Suite 700, Flowood MS 39232-7620. He recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Dental Providers / Dentist. Dental Providers / Dentist is his primary health care specialty. Willis, Sheldon can be contacted via phone (601) 933-0009.

Contact Information

Primary practice address
1000 Lakeland Square Ext Suite 700 Flowood MS 39232-7620
Phone: (601) 933-0009
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 3279-03 Mississippi
Dental Providers / Dentist 122300000X D6926 Arizona

Profile Details

NPI number 1013016104
LBN Legal business name Willis, Sheldon
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 22nd, 2006
Last updated Jun 28th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013016104 NPPES
Mississippi MEDICAID 04350504

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