Wallis Dental Corporation

NPI 1538551924 - Dentist - 1223G0001X

NPI Details
NPI 1538551924
Enumeration Date 02/23/2015
Last Updated 02/23/2015
Entity Type Healthcare Provider
Active Over 1 year ago
Authorized Information
Name KENNETH KENNETH
Position PRESIDENT
Phone (408) 248-6777
Fax
Practice Location
265 CRESTVIEW DR
SANTA CLARA CA, 95050-6503, US
Phone (408) 248-6777
Fax
Business Location
265 CRESTVIEW DR
SANTA CLARA CA, 95050-6503, US
Phone (408) 248-6777
Fax
Toxanomy
Taxonomy Code 1223G0001X
License State California
License Number 34914
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According to our database, Wallis Dental Corporation NPI is 1538551924, taxonomy code is 1223G0001X and license number is 34914, license state is located at California. Wallis Dental Corporation physically located at 265 Crestview Dr, Santa Clara CA, 95050-6503. NPI Number 1033115704 has the healthcare provider type.

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1538551924 NPI number is provided on an as is basis without warranty of any kind. 1538551924 is maintained by the National Plan & Provider Enumeration System. The contents of Wallis Dental Corporation are for informational purposes only.