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Individual

ADAM WALLUM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
307 BOATNER RD STE 114, EGLIN AFB, FL 32542-1302
(850) 883-8803
Mailing address
307 BOATNER RD STE 114, EGLIN AFB, FL 32542-1302

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
DN22266
FL
1223G0001X
General Practice Dentistry
Primary
DN22266
FL

Other

Enumeration date
02/29/2016
Last updated
07/28/2025
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