DR. Samuel Moore Wallden, D.M.D.

NPI #1811348287 in Rockford, Illinois

Provider Information

NPI Number
1811348287
Entity Type
Individual
Name
DR. Samuel Moore Wallden, D.M.D.
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Dentist - General Practice
Credential
D.M.D.
Enumeration Date
Jun 28, 2016
Last Updated
Jun 28, 2016

Practice Location

Address
6075 VANTAGE PL
ZIP Code
61107-5905
Phone
(815) 399-0677

Specialties & Taxonomy Codes

Specialty
Dentist - General PracticeGeneral Practice

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