Individual
DR. DANIEL CLAYBOURN WALTERS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
580 FARRINGDOM ST, LUMBERTON, NC 28358-2615
(910) 671-4601
Mailing address
580 FARRINGDOM ST, LUMBERTON, NC 28358-2615
(910) 671-4601
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8190
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5909749
—
NC
Enumeration date
10/02/2008
Last updated
10/02/2008
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