Laurence Edward Will Jr., DDS

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

License

D9868 Issued in MN

Practice address

1000 Lakeshore Dr
Moose Lake, MN 55767-9449

Phone

(218) 485-5100

NPI assigned

Dec 5, 2023

Last updated

Apr 26, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1701734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1679340160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 LAKESHORE DR",
            "city": "MOOSE LAKE",
            "state": "MN",
            "postal_code": "557679449",
            "telephone_number": "218-485-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 LAKESHORE DR",
            "city": "MOOSE LAKE",
            "state": "MN",
            "postal_code": "557679449",
            "telephone_number": "218-485-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILL",
        "first_name": "LAURENCE",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-12-05",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "MN",
            "license": "D9868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Public Health Dentistry in Moose Lake, MN
• Providers in Moose Lake, MN by specialty
• Public Health Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.