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Individual

DR. KURT DAVID WALLIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
2934 W INA RD, TUCSON, AZ 85741-2110
(480) 432-2000
Mailing address
3648 E JANELLE WAY, GILBERT, AZ 85298-4836
(480) 432-2000

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
DS038653
PA
1223P0300X
Periodontics
Primary
D008400
AZ

Other

Enumeration date
05/31/2011
Last updated
12/13/2012
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