Individual
DR. GERALD E WALTON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
5604 NE ANTIOCH RD, GLADSTONE, MO 64119-2378
(816) 453-9600
(816) 453-9600
Mailing address
5604 NE ANTIOCH RD, GLADSTONE, MO 64119-2378
(816) 453-9600
(816) 453-9600
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
012944
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08309017
BLUE CROSS/BLUE SHIELD
MO
Enumeration date
07/20/2005
Last updated
07/08/2007
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