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Dale Willoughby, DDS
NPI 1700880556 · on the registry since 2005 · sole proprietor
Practice
- Address
- 6707 39th Ave
Kenosha, WI 53142 - Phone
- (262) 658-3559
- Fax
- (262) 658-0276
- Organisation at this address
- Kenosha Oral Surgery, S.C.
Inferred from a shared address, not stated in the registry.
Registry record
- Primary taxonomy
- 1223S0112X
1223S0112X
- Licence states on file
- WI
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2022-06-02
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Wisconsin