Individual
DR. JEFFERY WALTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
7006 S CENTRAL AVE, PHOENIX, AZ 85042-5423
(602) 276-1029
(602) 276-1838
Mailing address
7006 S CENTRAL AVE, PHOENIX, AZ 85042-5423
(602) 276-1029
(602) 276-1838
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D4930
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
493578
AHCCCS
AZ
Enumeration date
06/27/2006
Last updated
07/08/2007
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