Individual
DR. J. MICHAEL WALZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1400 E 2ND ST, DEFIANCE, OH 43512-2440
(419) 782-7950
(419) 782-8880
Mailing address
PO BOX 218, DEFIANCE, OH 43512-0218
(419) 782-7950
(419) 782-8880
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
13385
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0197175
—
OH
01
—
13385
LICENSE NUMBER
OH
01
—
929898
UNITED CONCORDIA
OH
Enumeration date
03/21/2007
Last updated
07/08/2007
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