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1801915939
WALLACE RAY BLACKWELDER
ROWLAND HEIGHTS, CA
NPI
1801915939
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
122300000X Dentist
(Licence: CA 031897)
Enumeration Date
2007-03-28
Last Update Date
2012-06-13
Business Address
Dr. WALLACE RAY BLACKWELDER D.D.S.
19728 COLIMA RD
ROWLAND HEIGHTS, CA 91748-3210
Phone number: 909-594-1758
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Mailing Address
Dr. WALLACE RAY BLACKWELDER D.D.S.
19728 COLIMA RD
ROWLAND HEIGHTS, CA 91748-3210
Phone number: 909-594-1758
Copy
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