Individual
DR. WALLACE KRIS ROSANDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2059 EAST 3900 SOUTH, SALT LAKE CITY, UT 84124
(801) 278-5000
Mailing address
2608 HILLSIDE PINES CIRCLE, SALT LAKE CITY, UT 84109
(801) 272-6001
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1373619922
UT
Other
Enumeration date
10/03/2006
Last updated
07/08/2007
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