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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