Individual
TRAVIS CHRISTOPH FAGALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DENTURIST
Contact information
Practice address
217 S 2ND AVE, WALLA WALLA, WA 99362-3002
(509) 525-7250
(509) 526-5295
Mailing address
217 S 2ND AVE, WALLA WALLA, WA 99362-3002
(509) 525-7250
(509) 526-5295
Taxonomy
Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
DN 60208462
WA
Other
Enumeration date
11/21/2011
Last updated
11/21/2011
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