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General NPI Number Information
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NPI Number | 1699072892
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Entity Type | Individual
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Provider Name | TEENA WALI DDS
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Gender | Female
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Dates
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Enumeration Date | 02/24/2011
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Last Update Date | 09/04/2024
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Provider Practice Location Address
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Address Line | 1281 E LA HABRA BLVD
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City | LA HABRA
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State | CA
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Zip | 90631-5600
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Country | US
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Telephone | 562-697-3788
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Fax |
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Provider Business Mailing Address
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Address Line | 1937 DANA PL
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City | FULLERTON
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State | CA
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Zip | 92831-1216
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Country | US
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Telephone | 412-298-5460
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 107082
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DS038418
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 16614
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License Number State | MD
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