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General NPI Number Information
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NPI Number | 1063835569
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Entity Type | Individual
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Provider Name | OLIVER LEE WILLHAM DDS, MS
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Gender | Male
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Dates
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Enumeration Date | 02/04/2014
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Last Update Date | 02/04/2014
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Provider Practice Location Address
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Address Line | 7400 FLEUR DR STE 100
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City | DES MOINES
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State | IA
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Zip | 50321-3105
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Country | US
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Telephone | 515-285-6134
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Fax | 515-285-2249
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Provider Business Mailing Address
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Address Line | 7400 FLEUR DR STE 100
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City | DES MOINES
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State | IA
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Zip | 50321-3105
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Country | US
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Telephone | 515-285-6134
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Fax | 515-285-2249
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 7331
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License Number State | IA
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