KENNETH GREGG WALLIS

SANTA CLARA, CA
NPI1538350038
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: CA  34914)
Enumeration Date2007-08-08
Last Update Date2007-08-08
Business Address
Dr. KENNETH GREGG WALLIS DDS
265 CRESTVIEW DR
SANTA CLARA, CA 95050-6503
Phone number: 408-248-6777
Mailing Address
Dr. KENNETH GREGG WALLIS DDS
265 CRESTVIEW DR
SANTA CLARA, CA 95050-6503
Phone number: 408-248-6777