Individual
DR. JEFFREY SAMUEL WALLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
17 W ORMOND AVE, CHERRY HILL, NJ 08002-3041
(856) 428-4445
(856) 428-4497
Mailing address
17 W ORMOND AVE, CHERRY HILL, NJ 08002-3041
(856) 428-4445
(856) 428-4497
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
22DI02571300
NJ
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
22DI02571301
NJ
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DS038160
PA
Other
Enumeration date
07/20/2010
Last updated
10/30/2014
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