DR. CRAIG L WILLIS (NPI# 1639235559) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639235559 |
| Entity Type | Individual |
| Full Name | DR. CRAIG L WILLIS |
| Credential | DDS |
| Practice Address |
1340 North 600 East Suite 2 Logan UT 84341 |
| Practice Telephone | 4357530462 |
| Practice Fax Number | 4357537011 |
| Mailing Telephone | 4357530462 |
| Mailing Fax Number | 4357537011 |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
3565169921 | UT | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346694494 | Craig August Willis | Physical Therapist | 790 Remington Blvd, Bolingbrook, IL 60440-4909 | 2016-04-14 |
| 1346276136 | Craig B. Willis | Orthopaedic Surgery | 4750 E Galbraith Rd, Suite 105, Cincinnati, OH 45236-6705 | 2006-06-23 |
| Street Address |
1340 NORTH 600 EAST SUITE 2 |
| City | LOGAN |
| State | UT |
| Zip Code | 84341 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578679205 | Morris N Poole | Dentist | 1340 North 600 East, Suite 2, Logan, UT 84341 | 2006-08-23 |
| 1194023473 | Morris Lewis Poole | Dentist | 1340 North 600 East, Suite #2, Logan, UT 84341 | 2011-03-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538701529 | Aubrey Salmond | Registered Nurse | 500 East 1500 N, Logan, UT 84341 | 2019-10-11 |
| 1043702046 | Eye Pros of Logan LLC | Optometrist | 1475 N Main St Ste 103, Logan, UT 84341 | 2018-06-05 |
| 1275050452 | Rylie Jeanne Cook | Student in an Organized Health Care Education/Training Program | 11 Aggie Village Apt. J, Logan, UT 84341 | 2017-08-28 |
| 1093262156 | Jessica Lynn Mcgarry | Social Worker | 1040 N 130 W, Apt 100, Logan, UT 84341 | 2016-09-07 |
| 1740663566 | Paul R Gregory | Occupational Therapy Assistant | 1300 N 500 E Suite 120, Suite 120, Logan, UT 84341 | 2015-06-30 |
| 1851708846 | Bradley Budge | Optometrist | 535 E 1400 N Ste 130, Logan, UT 84341 | 2014-07-22 |
| 1386058709 | Daniel Raymond Carlson | Physician Assistant | 500 E. 1400 N., Logan, UT 84341 | 2014-06-13 |
| 1902220239 | Work Injury Solutions Inc. | Clinic/Center | 630 E 1400 N Ste 140, Logan, UT 84341 | 2014-02-06 |
| 1750627287 | Lee Martin Williams Sr. | Counselor | 186 E. 1800 N., North Logan, UT 84341 | 2013-01-03 |
| 1669747804 | Ronald J Payne | Internal Medicine | 1726 North 1850 East, North Logan, UT 84341 | 2012-03-21 |
| Find all providers in zip 84341 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821553785 | Raymond Scott Hlavaty | Dentist | 150 E 200 N Ste A, Logan, UT 84321-4036 | 2019-02-05 |
| 1942683214 | Poole and Willis Orthodontics | Dentist | 1340 N 600 E Ste 2, Logan, UT 84341-2475 | 2015-07-06 |
| 1003133174 | Russell J Guymon | Dentist | 191 N 200 E, Logan, UT 84321-4605 | 2010-04-28 |
| 1023186111 | Raymond Scott Hlavaty | Dentist | 150 E 200 No, Ste A, Logan, UT 84321 | 2006-11-30 |
| 1578679205 | Morris N Poole | Dentist | 1340 North 600 East, Suite 2, Logan, UT 84341 | 2006-08-23 |
| 1003822032 | Ralph K Bair | Dentist | 1445 N 400 E, Suite 3, Logan, UT 84341-7564 | 2006-07-31 |
| 1285181131 | Thomson Orthodontics | Dentist | 1445 N 400 E Ste 3, Logan, UT 84341-7564 | 2016-09-08 |
| 1164896312 | William Alder | Dentist | 160 S Mulberry St, Logan, OH 43138 | 2015-11-25 |
| 1194023473 | Morris Lewis Poole | Dentist | 1340 North 600 East, Suite #2, Logan, UT 84341 | 2011-03-10 |
| 1033310750 | W. Daniel Alder Dds Ms Inc | Dentist | 160 S Mulberry St, Logan, OH 43138-1292 | 2007-05-30 |
| Find all providers in LOGAN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.