Individual provider · Type 1 NPI

Mark Robert Vande Walle, DDS

Dentist · Green Bay, WI

NPI number 1083749774 Active

Practice location

1711 Shawano Ave
Green Bay, WI 54303

Call (920) 494-9541 Map

Specialties and licenses

TaxonomyCodeLicense
Dentist Primary 122300000X003209 (WI)

Dentist: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requiremen…

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About NPI 1083749774

Mark Robert Vande Walle, DDS's National Provider Identifier is 1083749774, issued on Feb 22, 2007. The primary taxonomy on file is Dentist (122300000X), and the practice location is in Green Bay, WI. The record was last updated on Jul 8, 2007.