Organization
JAMES M. WALTER, JR, DDS, MS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES M WALTER JR. DDS MS (OWNER)
(336) 768-9881
Entity
Organization
Contact information
Practice address
3020 MAPLEWOOD AVENUE, WINSTON SALEM, NC 27103
(336) 768-9881
(336) 768-6066
Mailing address
3020 MAPLEWOOD AVENUE, WINSTON SALEM, NC 27103
(336) 768-9881
(336) 768-6066
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
—
NC
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
4128
NC
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
7036
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890191N
—
NC
Enumeration date
05/17/2006
Last updated
11/14/2012
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