Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 57656 | CA |
Y | 1223D0004X | Dentist Anesthesiologist | 040142934 | VA |
N | 1223D0004X | Dentist Anesthesiologist | 9109 | TN |
NPI | 1407001811 |
---|---|
Provider Name | John T. Will |
First Address | Charlottesville, VA 22902-5940 |
Second Address | Charlottesville, VA 22911-4662 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/11/2008 |
Last Update Date | 05/10/2021 |