Individual
DR. RYAN WILLIAM WALTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
5 GROVER ST, SUCCASUNNA, NJ 07876-1010
(973) 584-1193
Mailing address
5 GROVER ST, SUCCASUNNA, NJ 07876-1010
(973) 584-1193
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
22DI02586500
NJ
Other
Enumeration date
03/17/2015
Last updated
03/17/2015
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