Provider Demographics
NPI:1184681405
Name:WILL SURGICAL ARTS LLC
Entity Type:Organization
Organization Name:WILL SURGICAL ARTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:WILL
Authorized Official - Suffix:
Authorized Official - Credentials:MD, DDS
Authorized Official - Phone:301-874-1707
Mailing Address - Street 1:PO BOX 7899
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72766-7899
Mailing Address - Country:US
Mailing Address - Phone:479-464-5824
Mailing Address - Fax:479-725-2395
Practice Address - Street 1:3280 URBANA PIKE
Practice Address - Street 2:SUITE 201
Practice Address - City:IJAMSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21754-9403
Practice Address - Country:US
Practice Address - Phone:301-874-1707
Practice Address - Fax:301-874-1730
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD121621223S0112X
MD052372204E00000X, 208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty
Not Answered204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial SurgeryGroup - Multi-Specialty
Not Answered208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Multi-Specialty