Jon Ryan Wallis, DMD

NPI #1821510728 in Casa Grande, Arizona

Provider Information

NPI Number: 1821510728
Entity Type: Individual
Name: Jon Ryan Wallis, DMD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: DMD
Enumeration Date: Jul 12, 2017
Last Updated: Jul 12, 2017

Practice Location

Address: 2028 N TREKELL RD STE 107
City: Casa Grande
State: Arizona
ZIP Code: 85122-1326
Phone: (520) 876-9955

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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