Organization
CHARLES C WALL DDS
Active
Other names
Wall Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES C WALL DDS (OWNER)
(801) 278-3864
Entity
Organization
Contact information
Practice address
2200 EAST 4500 SOUTH, SUITE 240, SALT LAKE CITY, UT 84117
(801) 278-3864
(801) 278-3868
Mailing address
2200 EAST 4500 SOUTH, SUITE 240, SALT LAKE CITY, UT 84117
(801) 278-3864
(801) 278-3868
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
51343669922
UT
Other
Enumeration date
04/12/2007
Last updated
07/22/2008
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