Organization
LAURA G WALLS FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAURA G WALLS DMD (DENTIST OWNER)
(803) 532-3331
Entity
Organization
Contact information
Practice address
533 W CHURCH ST, BATESBURG, SC 29006-1706
(803) 532-3331
(803) 532-3310
Mailing address
533 W CHURCH ST, BATESBURG, SC 29006-1706
(803) 532-3331
(803) 532-3310
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
SC3590
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1972513349
INDIVIDUAL NPI NUMBER
SC
05
—
Z35908
—
SC
05
—
ZA9578
—
SC
Enumeration date
04/11/2007
Last updated
04/03/2008
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