Individual
DR. KEVIN S WALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
340 FAIRFIELD AVE, BELLEVUE, KY 41073-1175
(859) 291-7621
(859) 291-0048
Mailing address
340 FAIRFIELD AVE, BELLEVUE, KY 41073-1175
(859) 291-7621
(859) 291-0048
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6165
KY
Other
Enumeration date
03/14/2007
Last updated
01/21/2014
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