Healthcare Provider Details

I. General information

NPI: 1184681405
Provider Name (Legal Business Name): WILL SURGICAL ARTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3280 URBANA PIKE SUITE 201
IJAMSVILLE MD
21754-9403
US

IV. Provider business mailing address

PO BOX 7899
SPRINGDALE AR
72766-7899
US

V. Phone/Fax

Practice location:
  • Phone: 301-874-1707
  • Fax: 301-874-1730
Mailing address:
  • Phone: 479-464-5824
  • Fax: 479-725-2395

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number12162
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number052372
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License Number052372
License Number StateMD

VIII. Authorized Official

Name: DR. MICHAEL J WILL
Title or Position: OWNER
Credential: M.D., D.D.S.
Phone: 301-874-1707