# WALLS FAMILY DENTISTRY, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Matthew Walls, DDS
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679740898
- **Authorized official:** DR. MATTHEW WALLS DDS (PRESIDENT/DENTIST)
- **Authorized official phone:** (918) 486-0039

## Contact information

- **Practice address:** 12627 S HIGHWAY 51, COWETA, OK 74429-6476
- **Practice address phone:** (918) 486-0039
- **Practice address fax:** (918) 486-0097
- **Mailing address:** 12627 S HIGHWAY 51, COWETA, OK 74429-6476
- **Mailing address phone:** (918) 486-0039
- **Mailing address fax:** (918) 486-0097

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | OK5393 | OK | Yes |

## Other

- **Enumeration date:** 05/15/2008
- **Last updated:** 03/30/2009