Willis, Shaun
Willis, Shaun is an sole proprietor health care provider with primary practice located at 1108 N Mechanic St , El Campo TX 77437. He recently has 2 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Dental Providers / General Practice. Dental Providers / General Practice is his primary health care specialty. Willis, Shaun can be contacted via phone (979) 541-5400.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | ||
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | 27076 | Texas |
| Dental Providers / General Practice | 1223G0001X | 27076 | Texas |
Profile Details
| NPI number | 1942597976 |
|---|---|
| LBN Legal business name | Willis, Shaun |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 28th, 2011 |
| Last updated | Oct 15th, 2018 - about 8 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1942597976 | NPPES |
| Texas | Other | 27076 | TEXAS DENTAL LICENSE |
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