| NPI | 1578802450 |
|---|---|
| Doing Business As | WALTER DENTAL |
| Entity Type | Organization |
| Authorized Contact | WALTER RONG Dentist 626-339-7012 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CA 50094) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2013-02-12 |
| Last Update Date | 2021-11-01 |