Organization
WESTGATE PERIODONTICS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KURT D WALLIN D.M.D. (OWNER/DENTIST)
(623) 848-1901
Entity
Organization
Contact information
Practice address
6535 W CAMELBACK RD, SUITE #1, PHOENIX, AZ 85033-1608
(623) 848-1901
(623) 848-8778
Mailing address
6535 W CAMELBACK RD, SUITE #1, PHOENIX, AZ 85033-1608
(623) 848-1901
(623) 848-8778
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
D008400
AZ
Other
Enumeration date
05/20/2016
Last updated
05/20/2016
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