Individual
TRACY DEAN WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS MS
Contact information
Practice address
7808 MAHAN GAP RD, OOLTEWAH, TN 37363-5708
(805) 794-5842
Mailing address
4980 S LEE HWY UNIT 22, MC DONALD, TN 37353-5786
(805) 794-5842
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
10163
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q030018
—
TN
Enumeration date
08/13/2006
Last updated
05/25/2018
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