Kory Wallin, DMD
Dentist in Longmont, CO. Individual provider (NPI-1).
NPI number1477818052
StatusActive
Last updated in NPPESFeb 17, 2023
Details
- NPI
- 1477818052
- Entity type
- Individual (NPI-1)
- Name
- Kory Wallin
- Credential
- DMD
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jul 10, 2012
- Certification date
- Feb 17, 2023
- Last updated
- Feb 17, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 10742 | CO | Yes |
Practice location
1100 Ken Pratt Blvd Ste ELongmont, CO 80501-6380
Phone 720-458-6684
Mailing address
1100 Ken Pratt Blvd Unit ELongmont, CO 80501
Phone 720-505-9422
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All 47 Dentist providers in Longmont · All 3,303 providers in Longmont
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