Individual
BLAKE SCOTT WALROND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS PA
Contact information
Practice address
2607 TABERNACLE CHURCH ROAD, PLEASANT GARDEN, NC 27313
(336) 674-2328
(336) 674-7158
Mailing address
PO BOX 515, PLEASANT GARDEN, NC 27313
(336) 674-2328
(336) 674-7158
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5967
NC
Other
Enumeration date
04/16/2007
Last updated
07/08/2007
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