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Organization

ANDREW J. WALLS DDS, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ANDREW JAMES WALLS DDS (PRESIDENT)
(405) 485-6080
Entity
Organization

Contact information

Practice address
1019 N COUNCIL AVE, SUITE #2, BLANCHARD, OK 73010-8003
(405) 485-6080
(405) 485-6089
Mailing address
PO BOX 880, BLANCHARD, OK 73010-0880
(405) 485-6080
(405) 485-6089

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
5630
OK

Other

Enumeration date
03/11/2009
Last updated
03/11/2009
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