Individual
DR. BRUCE L. WALTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5740 W GRANDE MARKET DR, APPLETON, WI 54913-8406
(920) 735-9950
(920) 735-9953
Mailing address
5740 W GRANDE MARKET DR, APPLETON, WI 54913-8406
(920) 735-9950
(920) 735-9953
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4776
WI
Other
Enumeration date
03/28/2007
Last updated
07/08/2007
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