Individual
DR. BENJAMIN EARL WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
10894 S RIVER FRONT PKWY, SOUTH JORDAN, UT 84095-5609
(801) 878-1471
Mailing address
1347 E ESTRELLITA DR, SANDY, UT 84093-1250
(602) 785-1882
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8495
AZ
122300000X
Dentist
8892816-9921
UT
122300000X
Dentist
DE60118562
WA
1223G0001X
General Practice Dentistry
DEN-9427
CO
Other
Enumeration date
03/21/2008
Last updated
05/16/2014
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