Individual
KEVIN C WALDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.
Contact information
Practice address
1507 HERITAGE HILLS DR, WASHINGTON, MO 63090-4614
(636) 239-5151
(636) 390-2728
Mailing address
1507 HERITAGE HILLS DR, WASHINGTON, MO 63090-4614
(636) 239-5151
(636) 390-2728
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
013936
MO
Other
Enumeration date
06/04/2007
Last updated
06/04/2014
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