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Individual

RYAN WALTERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
850 NORMAN DR, LEBANON, PA 17042-7444
(609) 405-9011
Mailing address
225 E LINCOLN AVE, LITITZ, PA 17543-1126
(609) 405-9011

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DSO41795
PA

Other

Enumeration date
06/29/2018
Last updated
06/29/2018
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