Individual
DR. PAUL K WALLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1270 COPE AVE E, MAPLEWOOD, MN 55109
(651) 482-8332
Mailing address
1270 COPE AVE E, MAPLEWOOD, MN 55109
(651) 482-8332
(651) 482-7839
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9636
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
56701WA
BLUE CROSS BLUE SHIELD
MN
Enumeration date
09/28/2006
Last updated
07/08/2007
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