Individual
EMMA WALLESTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
471 HEPBURN ST, WILLIAMSPORT, PA 17701-6122
(570) 567-5400
Mailing address
19 CENTER PL, WILLIAMSPORT, PA 17701-6013
(319) 596-5776
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH075755
PA
Other
Enumeration date
08/21/2025
Last updated
08/21/2025
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