Individual
DR. TERRY R WALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
118 SW 330TH ST, STE 200, FEDERAL WAY, WA 98023-6185
(253) 838-0765
(253) 838-3416
Mailing address
118 SW 330TH ST, STE 200, FEDERAL WAY, WA 98023-6185
(253) 838-0765
(253) 838-3416
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
4272
WA
Other
Enumeration date
09/23/2009
Last updated
09/23/2009
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