Individual
DR. DOUGLAS GLEN WALESHECK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1346 PAYNE AVE, SAINT PAUL, MN 55101-3434
(651) 774-6085
(651) 774-2660
Mailing address
1346 PAYNE AVE, SAINT PAUL, MN 55101-3434
(651) 774-6085
(651) 774-2660
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D7367
MN
Other
Enumeration date
12/12/2005
Last updated
07/08/2007
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