IndividualActive
Alyssa Waller
NPI 1215805585 · Dental Hygienist · Green Bay, WI
Provider details
- NPI number
- 1215805585
- Entity type
- Individual
- Primary specialty
- Dental HygienistDental Providers
- Sex
- Female
- Sole proprietor
- No
- License
- 10302-16 (WI)
Specialties & taxonomies
Dental Providers
Practice location
1245 Main St
Green Bay, WI 54302-1306
Phone: (920) 965-0831
Approximate (ZIP-level) locationGet directions
Mailing address
1245 Main St
Green Bay, WI 54302-1306
Registry dates
- Enumerated
- 2025-10-28
- Last updated
- 2025-10-28
- Certified
- 2025-10-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.