Individual
DR. WALTER FRED THAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1 LAKE ST, BUILDING B, NEW BRITAIN, CT 06052-1396
(860) 224-2419
(860) 224-3095
Mailing address
1 LAKE ST, BUILDING B, NEW BRITAIN, CT 06052-1396
(860) 224-2419
(860) 224-3095
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
05256
CT
Other
Enumeration date
01/19/2007
Last updated
07/08/2007
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