IndividualActive
Craig Willis, DDS
NPI 1639235559 · Orthodontics and Dentofacial Orthopedics Dentistry · Logan, UT
Provider details
- NPI number
- 1639235559
- Entity type
- Individual
- Primary specialty
- Orthodontics and Dentofacial Orthopedics DentistryDental Providers
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- No
- License
- 3565169921 (UT)
Specialties & taxonomies
Dental Providers
Practice location
2245 N 400 E
Suite 103
Logan, UT 84341
Phone: (435) 753-6776
Fax: (435) 753-7011
Approximate (ZIP-level) locationGet directions
Mailing address
2245 N 400 E
Logan, UT 84341
Registry dates
- Enumerated
- 2006-12-28
- Last updated
- 2022-03-16
- Certified
- 2022-03-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.