Search › New Mexico › 122300000X
Jared Wallis, DDS
NPI 1396033494 · on the registry since 2011
Practice
- Address
- 2540 N Telshor Blvd Ste E
Las Cruces, NM 88011 - Phone
- (575) 521-9375
- Fax
- (575) 521-2637
- Organisation at this address
- Northrise Dental Llc
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 5
Registry record
- Primary taxonomy
- 122300000X
122300000X
- Also registered as
- 1223G0001X
- Licence states on file
- NM
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2019-02-11
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in New Mexico