# DR. DAVID A. WALLS, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013882323
- **Authorized official:** THERESA K SHEPPARD RDA (BUSINESS ASSISTANT)
- **Authorized official phone:** (209) 522-9963

## Contact information

- **Practice address:** 1316 COFFEE RD STE E14, MODESTO, CA 95355-3191
- **Practice address phone:** (209) 522-9963
- **Practice address fax:** (209) 522-5184
- **Mailing address:** 1316 COFFEE RD STE E14, MODESTO, CA 95355-3191
- **Mailing address phone:** (209) 522-9963
- **Mailing address fax:** (209) 522-5184

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 10/07/2025
- **Last updated:** 10/07/2025