Wallis Dental LLC
Clinic/Center, Dental in Lexington, MA. Organization (NPI-2).
NPI number1831867985
StatusActive
Last updated in NPPESSep 2, 2021
Details
- NPI
- 1831867985
- Entity type
- Organization (NPI-2)
- Legal business name
- Wallis Dental LLC
- Organization subpart
- No
- Enumeration date
- Sep 2, 2021
- Certification date
- Sep 2, 2021
- Last updated
- Sep 2, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | – | – | Yes |
Practice location
1 Wallis Ct Ste 4Lexington, MA 02421-5416
Phone 781-862-6565
Mailing address
1 Wallis Ct Ste 4Lexington, MA 02421-5416
Phone 781-862-6565
Authorized official
Min Jung Kim
Dr.
7818626565
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