Organization
BDC BARSTOW
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LUANNE DENISE WALTERS (MEDICAL STAFF SERVICE PROFESSIONAL)
(760) 725-3213
Entity
Organization
Contact information
Practice address
14TH STREET, BUILDING 13128, CAMP PENDLETON, CA 92055-5221
(760) 725-3213
(760) 725-8223
Mailing address
PO BOX 555221, CAMP PENDLETON, CA 92055-5221
(760) 725-3213
(760) 725-8223
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
01/28/2008
Last updated
01/28/2008
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