Individual
MR. CARL STEPHEN WALLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
101 1ST AVE SW, GLENWOOD, MN 56334-1503
(320) 634-4543
(320) 634-4544
Mailing address
101 1ST AVE SW, PO BOX 174, GLENWOOD, MN 56334-1503
(320) 634-4543
(320) 634-4544
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D12086
MN
Other
Enumeration date
03/21/2006
Last updated
01/27/2023
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