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Organization

MATTHEW WALLA DDS PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GREGORY WHITE DDS (CEO)
(859) 533-1109
Entity
Organization

Contact information

Practice address
3985 MAIN ST, AMHERST, NY 14226-3404
(716) 832-1550
Mailing address
105 SPRUCE ST, LEXINGTON, KY 40507-2109

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary

Other

Enumeration date
07/11/2023
Last updated
07/11/2023
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