DR. Kenneth Gregg Wallis, DDS
NPI #1538350038 in Santa Clara, California
Provider Information
- NPI Number
- 1538350038
- Entity Type
- Individual
- Name
- DR. Kenneth Gregg Wallis, DDS
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Dentist - General Practice
- Credential
- DDS
- Enumeration Date
- Aug 8, 2007
- Last Updated
- Aug 8, 2007
Practice Location
- Address
- 265 CRESTVIEW DR
- City
- Santa Clara
- State
- California
- ZIP Code
- 95050-6503
- Phone
- (408) 248-6777
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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