Individual
CHAD WALTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
625 EICHENFELD DR, BRANDON, FL 33511-5908
(813) 654-3636
(813) 651-4984
Mailing address
3313 LAS CAMPOS PL, TAMPA, FL 33611-2968
(319) 331-6605
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
DN21983
FL
Other
Enumeration date
07/02/2014
Last updated
07/28/2016
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