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1477818052
KORY WALLIN
LONGMONT, CO
NPI
1477818052
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
122300000X Dentist
(Licence: CO 10742)
Enumeration Date
2012-07-10
Last Update Date
2023-02-17
Business Address
KORY WALLIN DMD
1100 KEN PRATT BLVD STE E
LONGMONT, CO 80501-6380
Phone number: 720-458-6684
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Mailing Address
KORY WALLIN DMD
1100 KEN PRATT BLVD UNIT E
LONGMONT, CO 80501
Phone number: 720-505-9422
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