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1811348287
SAMUEL MOORE WALLDEN
ROCKFORD, IL
NPI
1811348287
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: IL 019.030757)
Enumeration Date
2016-06-28
Last Update Date
2016-06-28
Business Address
Dr. SAMUEL MOORE WALLDEN D.M.D.
6075 VANTAGE PL
ROCKFORD, IL 61107-5905
Phone number: 815-399-0677
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Mailing Address
Dr. SAMUEL MOORE WALLDEN D.M.D.
6075 VANTAGE PL
ROCKFORD, IL 61107-5905
Phone number: 815-399-0677
Copy
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