Individual
DR. PAUL S VANWALLEGHEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
50505 SCHOENHERR RD, STE 170, SHELBY TOWNSHIP, MI 48315-3140
(586) 803-8300
Mailing address
50505 SCHOENHERR RD, STE 170, SHELBY TWP, MI 48315-3140
(313) 886-9201
(313) 881-5068
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D14525
MI
Other
Enumeration date
04/18/2007
Last updated
12/08/2011
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