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Organization
DR. DAVID A. WALLS, INC
Active
Organization
DR. DAVID A. WALLS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THERESA K SHEPPARD RDA (BUSINESS ASSISTANT)
(209) 522-9963
Entity
Organization
Contact information
Practice address
1316 COFFEE RD STE E14, MODESTO, CA 95355-3191
(209) 522-9963
(209) 522-5184
Mailing address
1316 COFFEE RD STE E14, MODESTO, CA 95355-3191
(209) 522-9963
(209) 522-5184
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
10/07/2025
Last updated
10/07/2025
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