Individual
DR. BRYAN SCOTT WALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
5308 N. TARRANT PKWY, KELLER, TX 76248-6293
(817) 750-0966
(817) 750-0968
Mailing address
5308 N. TARRANT PKWY, KELLER, TX 76248-6293
(817) 750-0966
(817) 750-0968
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
21100
TX
Other
Enumeration date
05/04/2007
Last updated
07/08/2007
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