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Individual

EDWARD K WALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
13 PETER BEHR DR, SAN RAFAEL, CA 94903-5216
(415) 473-6651
Mailing address
13 PETER BEHR DR, SAN RAFAEL, CA 94903-5216
(415) 473-6651

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
20980
CA

Other

Enumeration date
03/24/2026
Last updated
03/24/2026
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