Raymond A Waller, DDS

NPI #1922176528 in Clarkston, Washington

Provider Information

NPI Number: 1922176528
Entity Type: Individual
Name: Raymond A Waller, DDS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist - General Practice
Credential: DDS
Enumeration Date: Dec 1, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 1303 16TH AVE
City: Clarkston
State: Washington
ZIP Code: 99403-2956
Phone: (509) 758-7150

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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