Willoughby, Dale Wayne
Willoughby, Dale Wayne is an sole proprietor health care provider with primary practice located at 6707 39Th Ave , Kenosha WI 53142-7125. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Willoughby, Dale Wayne can be contacted via phone (262) 658-3559.Contact Information
Primary practice address
6707 39Th Ave
Kenosha WI 53142-7125
Phone: (262) 658-3559
Fax: (262) 658-0276
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 4998-015 | Wisconsin |
Profile Details
| NPI number | 1700880556 |
|---|---|
| LBN Legal business name | Willoughby, Dale Wayne |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 9th, 2005 |
| Last updated | Jun 2nd, 2022 - about 2 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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