Individual
DR. NICHOLAS PATRICK WALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3655 W ANTHEM WAY, SUITE A-117, ANTHEM, AZ 85086
(623) 551-5555
(623) 551-1620
Mailing address
3655 W ANTHEM WAY, SUITE A-117, ANTHEM, AZ 85086
(623) 551-5555
(623) 551-1620
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D12321
MN
Other
Enumeration date
03/09/2007
Last updated
08/19/2008
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