Individual
AMA D WALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1220 W CHESTER PIKE, HAVERTOWN, PA 19083-3339
(484) 454-3230
Mailing address
1220 W CHESTER PIKE, HAVERTOWN, PA 19083-3339
(484) 454-3230
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN031436A
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0182803704
—
PA
Enumeration date
10/17/2005
Last updated
04/29/2016
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