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Individual

WALTER LEWIS MOORHEAD III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
215 FRONT ST, WRANGELL, AK 99929-1140
(907) 874-3731
(907) 874-3531
Mailing address
PO BOX 1140, WRANGELL, AK 99929-1140
(907) 874-3731
(907) 874-3531

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
550
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
DD0550
AK
Enumeration date
11/01/2007
Last updated
11/01/2007
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