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:
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Health care specialties

SpecialtyCodeLicense #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 19 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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