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Organization

BILTMORE PERIODONTICS, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KURT D WALLIN D.M.D. (OWNER/DENTIST)
(602) 266-5896
Entity
Organization

Contact information

Practice address
1277 E MISSOURI AVE, SUITE 102, PHOENIX, AZ 85014-2915
(602) 266-5896
(602) 274-6114
Mailing address
1277 E MISSOURI AVE, SUITE 102, PHOENIX, AZ 85014-2915
(602) 266-5896
(602) 274-6114

Taxonomy

Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
D008400
AZ

Other

Enumeration date
05/06/2016
Last updated
05/06/2016
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