MEDICARE: DR. ARNOLD RICHARD WALLINS DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	M11128	MA

General Provider Information

NPI Number	:	1447235718
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARNOLD RICHARD WALLINS DDS

Provider Business Mailing Address
First Line	:	50 SALEM ST A
Second Line	:
City	:	LYNNFIELD
State	:	MA
Zip	:	01940-2600
Country	:	US
Telephone Number	:	781-246-2211
Fax Number	:	781-246-5566

Provider Business Practice Location Address
First Line	:	765 LOWELL ST
Second Line	:
City	:	PEABODY
State	:	MA
Zip	:	01960-3352
Country	:	US
Telephone Number	:	978-535-5090
Fax Number	:	978-535-5222

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/09/2005
Last Update Date	:	12/08/2015

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