Douglas M Wallen
Douglas M Wallen is a General Practice Dentistry in Champaign, Illinois. Practices as a sole proprietor. Licensed in Illinois.
- Licensed in
- IL
- In the registry since
- 2008
Practice location Address checks out
2502 Galen Dr Ste 103Champaign, IL 61821-7045
Phone: (217) 366-0050
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| General Practice Dentistry (primary) | Taxonomy 1223G0001X · Licence 019020653 (IL) |
|---|
Record details
| NPI number | 1407010176 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | July 11, 2008 |
| Last updated in NPPES | July 11, 2008 |
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