Wallis, Kenneth Gregg
Wallis, Kenneth Gregg is an sole proprietor health care provider with primary practice located at 265 Crestview Dr , Santa Clara CA 95050-6503. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Wallis, Kenneth Gregg can be contacted via phone (408) 248-6777.Contact Information
Primary practice address
265 Crestview Dr
Santa Clara CA 95050-6503
Phone: (408) 248-6777
Fax: (408) 248-1947
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Dental Providers / General Practice | 1223G0001X | 34914 | California |
Profile Details
NPI number | 1538350038 |
---|---|
LBN Legal business name | Wallis, Kenneth Gregg |
Credentials | Doctor of Dental Surgery (DDS) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Aug 8th, 2007 |
Last updated | Aug 8th, 2007 - about 17 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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