Carrillo-Medina, Wallace
Carrillo-Medina, Wallace is an sole proprietor health care provider with primary practice located at 2211 Delaney Dr , Burlington NC 27215-5263. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Carrillo-Medina, Wallace can be contacted via phone (336) 226-4714.Contact Information
Primary practice address
2211 Delaney Dr
Burlington NC 27215-5263
Phone: (336) 226-4714
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 055454 | New York |
| Dental Providers / General Practice | 1223G0001X | 9900 | North Carolina |
Profile Details
| NPI number | 1558649947 |
|---|---|
| LBN Legal business name | Carrillo-Medina, Wallace |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 2nd, 2011 |
| Last updated | Feb 24th, 2022 - about 3 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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