Blackwelder, Wallace Ray

Blackwelder, Wallace Ray is an sole proprietor health care provider with primary practice located at 19728 Colima Rd , Rowland Heights CA 91748-3210. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Blackwelder, Wallace Ray can be contacted via phone (909) 594-1758.

Contact Information

Primary practice address
19728 Colima Rd Rowland Heights CA 91748-3210
Fax: (909) 594-4158
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 031897 California

Profile Details

NPI number 1801915939
LBN Legal business name Blackwelder, Wallace Ray
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 28th, 2007
Last updated Jun 13th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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