Individual
DR. RENEE A WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
100 HYANNIS DR, HOLLY SPRINGS, NC 27540-8327
(919) 362-1394
(919) 362-1638
Mailing address
100 HYANNIS DR, HOLLY SPRINGS, NC 27540-8327
(919) 362-1394
(919) 362-1638
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6732
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
811370
UNITED CONCORDIA
—
01
—
9008P
BCBS
NC
Enumeration date
10/17/2006
Last updated
07/06/2011
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