Organization
CLINT WALKER DENTAL CORPORATION
Active
Other names
17th Street Modern Dentistry Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
CLINT WALKER DDS (OWNER)
(714) 224-0480
Entity
Organization
Contact information
Practice address
270 E 17TH ST STE 15, COSTA MESA, CA 92627-3845
(714) 224-0480
(714) 224-0480
Mailing address
PO BOX 920050, DALLAS, TX 75392-0050
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
04/24/2018
Last updated
05/11/2022
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