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Organization
WALIA DENTAL CORPORATION
Active
Organization
WALIA DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUMANPREET K WALIA DDS (OWNER DENTIST)
(408) 643-5757
Entity
Organization
Contact information
Practice address
3101 N TRACY BLVD, TRACY, CA 95376-1717
(408) 643-5757
Mailing address
3101 N TRACY BLVD, TRACY, CA 95376-1717
(408) 643-5757
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
58823
DENTIST
CA
Enumeration date
06/16/2021
Last updated
06/16/2021
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