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Organization

GARY K. WALDEN DMD & BRENDA C. WALDEN DMD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. GARY K WALDEN D.M.D. (OWNER)
(270) 782-0414
Entity
Organization

Contact information

Practice address
725A KENTON ST, BOWLING GREEN, KY 42101-4917
(270) 782-0414
(270) 782-0414
Mailing address
725A KENTON ST, BOWLING GREEN, KY 42101-4917
(270) 782-0414
(270) 782-0414

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5625
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6190072600
KY
Enumeration date
05/01/2007
Last updated
08/22/2020
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