Provider Demographics
NPI:1952136459
Name:TEENA WALI DDS INC
Entity type:Organization
Organization Name:TEENA WALI DDS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TEENA
Authorized Official - Middle Name:
Authorized Official - Last Name:WALI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:412-298-5460
Mailing Address - Street 1:1937 DANA PL
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92831-1216
Mailing Address - Country:US
Mailing Address - Phone:412-298-5460
Mailing Address - Fax:
Practice Address - Street 1:1937 DANA PL
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92831-1216
Practice Address - Country:US
Practice Address - Phone:412-298-5460
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-04
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty