Individual
CHARLES WALTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3400 SQUALICUM PKWY, SUITE 102, BELLINGHAM, WA 98225-1933
(360) 676-8920
(360) 676-5988
Mailing address
3400 SQUALICUM PKWY, SUITE 102, BELLINGHAM, WA 98225-1933
(360) 676-8920
(360) 676-5988
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
5632
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5030226
—
WA
Enumeration date
12/01/2006
Last updated
07/09/2007
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