Individual
DR. DERRICK JAMES WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
190 MARCELL DR NE, ROCKFORD, MI 49341-1300
(616) 884-5884
Mailing address
7429 WATERMARK DR, ALLENDALE, MI 49401-9616
(616) 204-6698
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901600184
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2901600184
MICHIGAN DENTAL LICENSE
MI
Enumeration date
06/17/2019
Last updated
06/17/2019
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