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Organization
WALTER F. TICKNER, DDS, INC.
Active
Organization
WALTER F. TICKNER, DDS, INC.
Active
Other names
Denture Center
Organization subpart
No
Provider details
NPI number
Authorized official
WALTER F. TICKNER DDS (OWNER/DENTIST)
(510) 351-1400
Entity
Organization
Contact information
Practice address
1736 E 14TH ST, SAN LEANDRO, CA 94577-4803
(510) 351-1400
(510) 351-3116
Mailing address
1736 E 14TH ST, SAN LEANDRO, CA 94577-4803
(510) 351-1400
(510) 351-3116
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
23418
CA
Other
Enumeration date
08/17/2006
Last updated
08/22/2020
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