Individual
TOREY J VANDE WALLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1800 STATE ROAD 16, LA CROSSE, WI 54601-3011
(608) 782-9667
Mailing address
1800 STATE ROAD 16, LA CROSSE, WI 54601-3011
(920) 737-6701
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
100151815
WI
Other
Enumeration date
05/23/2017
Last updated
01/23/2021
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