Healthcare Provider Details

I. General information

NPI: 1295699650
Provider Name (Legal Business Name): WILLOW DENTAL, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 WOBURN ST
READING MA
01867-2906
US

IV. Provider business mailing address

85 WOBURN ST
READING MA
01867-2906
US

V. Phone/Fax

Practice location:
  • Phone: 781-944-4940
  • Fax:
Mailing address:
  • Phone: 781-944-4940
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. TAYLOR MARGARET ELLIS
Title or Position: OWNER
Credential: DMD
Phone: 973-668-8456