Individual
JILLIAN ALEXANDRA WALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
B.D.S.
Contact information
Practice address
444 SO. 44TH STREET, UNMC PEDIATRIC DENTISTRY, OMAHA, NE 68198-5450
(402) 559-7954
(402) 559-9307
Mailing address
444 SO. 44TH STREET, UNMC PEDIATRIC DENTISTRY, OMAHA, NE 68198-5450
(402) 559-7954
(402) 559-9307
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
LL539
MD
Other
Enumeration date
04/22/2008
Last updated
10/19/2011
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