Individual
DR. CHRISTOPHER RYAN WALLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1125 W KAGY BLVD, SUITE 201, BOZEMAN, MT 59715-5881
(406) 585-1120
(406) 587-1988
Mailing address
1125 W KAGY BLVD, SUITE 201, BOZEMAN, MT 59715-5881
(406) 585-1120
(406) 587-1988
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
11503
MT
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
30.022811
OH
Other
Enumeration date
08/15/2008
Last updated
07/22/2016
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