Individual provider · Type 1 NPI
Mark O. Waller, DDS
General Practice Dentistry · Sussex, WI
NPI number
1679670046
Active
Practice location
N63 W23401 Main St
Sussex, WI 53089-0229
Fax (262) 246-6892
Mailing address
PO Box 229
Sussex, WI 53089-0229
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| General Practice Dentistry Primary | 1223G0001X | 3012 (WI) |
General Practice Dentistry: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Another provider at this address
Other general practice dentistry providers in Sussex
About NPI 1679670046
Mark O. Waller, DDS's National Provider Identifier is 1679670046, issued on Sep 20, 2006. The primary taxonomy on file is General Practice Dentistry (1223G0001X), and the practice location is in Sussex, WI. The record was last updated on Jul 8, 2007.