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Individual

DR. GERALD MAYNARD WALL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
1811 S RAINBOW BLVD, SUITE 101, LAS VEGAS, NV 89146-0894
(702) 562-5044
(702) 562-3289
Mailing address
1811 S RAINBOW BLVD, SUITE 101, LAS VEGAS, NV 89146-0894
(702) 562-5044
(702) 562-3289

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4543
NV

Other

Enumeration date
11/24/2006
Last updated
07/08/2007
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