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Individual

DR. KAMI K WALLNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
101 EAST MAIN STREET, SUITE 108, FRISCO, CO 80443
(970) 668-1029
Mailing address
6453 SCENIC HWY NE, BLACKDUCK, MN 56630-4340
(612) 210-9267

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
2016000084
MO
122300000X
Dentist
Primary
9963
CO

Other

Enumeration date
06/15/2009
Last updated
07/17/2018
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