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Douglas M Wallen
General Practice Dentistry in Champaign, Illinois
NPI 1407010176

Douglas M Wallen is a General Practice Dentistry based in Champaign, IL and is specialized in General Practice. Douglas M Wallen practices in Champaign, IL. The NPI Number for Douglas M Wallen is 1407010176 and holds a License No. 019020653 (Illinois).

The current practice location address for Douglas M Wallen is 2502 Galen Dr, Champaign, IL and can be reached out via phone at 217-366-0050.

Location: 2502 Galen Dr, Champaign, IL, 61821-7045
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1407010176
Provider Name
Douglas M Wallen
Credential
Provider Entity Type
Individual
Gender
Male
Address
2502 Galen Dr, Champaign, IL, 61821-7045
Phone Number
217-366-0050
Fax Number
Provider Enumeration Date
07/11/2008
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
2502 Galen Dr
City
Champaign
State
Illinois
Zip
61821-7045
Phone Number
217-366-0050
Fax Number
person
Provider Business Mailing Address Details
Address
2502 Galen Dr
City
Champaign
State
Illinois
Zip
61821-7045
Phone Number
217-366-0050
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
019020653 (Illinois)
Definition
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.
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