Provider Demographics
NPI:1184255101
Name:JOHN T. WILL, DDS, PLLC
Entity type:Organization
Organization Name:JOHN T. WILL, DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:T
Authorized Official - Last Name:WILL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:931-212-3197
Mailing Address - Street 1:211 SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22902-5940
Mailing Address - Country:US
Mailing Address - Phone:931-212-3197
Mailing Address - Fax:
Practice Address - Street 1:4045 RIVERSIDE DRIVE
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541-5173
Practice Address - Country:US
Practice Address - Phone:434-791-2142
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-29
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223D0004XDental ProvidersDentistDental AnesthesiologyGroup - Single Specialty