Organization
WALLIS DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MIN JUNG KIM DMD (DR.)
(781) 862-6565
Entity
Organization
Contact information
Practice address
1 WALLIS CT STE 4, LEXINGTON, MA 02421-5416
(781) 862-6565
Mailing address
1 WALLIS CT STE 4, LEXINGTON, MA 02421-5416
(781) 862-6565
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
09/02/2021
Last updated
09/02/2021
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