MEDICARE: DR. HAROLD D WALLIN JR. D.D.S.

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	1223P0106X	Oral and Maxillofacial Pathology Dentistry	60004	KS

General Provider Information

NPI Number	:	1851366926
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HAROLD D WALLIN JR. D.D.S.

Provider Business Mailing Address
First Line	:	8919 PARALLEL PKWY
Second Line	:	SUITE 480
City	:	KANSAS CITY
State	:	KS
Zip	:	66112-1636
Country	:	US
Telephone Number	:	913-334-6000
Fax Number	:	913-334-7990

Provider Business Practice Location Address
First Line	:	8919 PARALLEL PKWY
Second Line	:	SUITE 480
City	:	KANSAS CITY
State	:	KS
Zip	:	66112-1636
Country	:	US
Telephone Number	:	913-334-6000
Fax Number	:	913-334-7990

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

Provider Enumeration Date	:	02/21/2006
Last Update Date	:	07/09/2007

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Directions to “ DR. HAROLD D WALLIN JR. D.D.S.” Practice Location

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