Organization
DR. TODD W. WALTERS P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TODD WAYNE WALTERS D.D.S. (PRESIDENT -OWNER)
(574) 722-5313
Entity
Organization
Contact information
Practice address
800 FULTON ST STE 4A, LOGANSPORT, IN 46947-1579
(574) 722-5313
(574) 753-3025
Mailing address
800 FULTON ST STE 4A, LOGANSPORT, IN 46947-1579
(574) 722-5313
(574) 753-3025
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12008831
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100070910
—
IN
Enumeration date
10/27/2006
Last updated
02/25/2011
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