# WALLING DENTAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073844338
- **Authorized official:** MELISSA NEWTON (OFFICE MANAGER)
- **Authorized official phone:** (931) 657-5204

## Contact information

- **Practice address:** 11765 MCMINNVILLE HWY, WALLING, TN 38587-5040
- **Practice address phone:** (931) 657-5204
- **Practice address fax:** (931) 657-2134
- **Mailing address:** 11765 MCMINNVILLE HWY, WALLING, TN 38587-5040
- **Mailing address phone:** (931) 657-5204
- **Mailing address fax:** (931) 657-2134

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DS1997 | TN | Yes |
| 1223G0001X | General Practice Dentistry | DS4172 | TN | — |

## Other

- **Enumeration date:** 01/26/2010
- **Last updated:** 01/26/2010