Individual
DR. CRYSTAL LYNN WALLENIUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2292 DALTON DR STE F, CLARKSVILLE, TN 37043-8961
(931) 503-1111
Mailing address
2292 DALTON DR STE F, CLARKSVILLE, TN 37043-8961
(931) 503-1111
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6001117-15
WI
Other
Enumeration date
01/03/2022
Last updated
08/04/2023
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