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Individual

DR. JAMES PHILIP WALL SR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
754 COUNTRY WAY, SCITUATE, MA 02066-1825
(781) 545-4181
(781) 545-3928
Mailing address
754 COUNTRY WAY, SCITUATE, MA 02066-1825
(781) 545-4181
(781) 545-3928

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
14445
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0014445
DELTA DENTAL
MA
01
X08245WA
BCBS
MA
Enumeration date
09/07/2006
Last updated
07/08/2007
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