NPI | 1659482206 |
---|---|
Former Legal Business Name | WALTON DENTAL HEALTH |
Entity Type | Organization |
Authorized Contact | SHAWN R WALTON Dentist 712-255-7607 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: IA 07610) |
Additional Taxonomies | 122300000X Dentist (Licence: IA 08441) |
Enumeration Date | 2006-08-31 |
Last Update Date | 2020-08-22 |