Individual
DR. BRIAN ERNEST WALDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
1410 SEMINARY ST, ALTON, IL 62002-4040
(217) 502-9780
Mailing address
1410 SEMINARY ST, ALTON, IL 62002-4040
(217) 502-9780
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2011030664
MO
Other
Enumeration date
09/13/2011
Last updated
09/13/2011
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