Individual
DR. STEPHEN ROBERT WALSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1840 WOODMOOR DR, MONUMENT, CO 80132-9091
(719) 481-8321
(719) 481-8405
Mailing address
1840 WOODMOOR DR, MONUMENT, CO 80132-9091
(719) 481-8321
(719) 481-8405
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
HDL 7210
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02072106
—
CO
01
—
550 07357
BCBS ALABAMA
AL
01
—
7210
DELTA
—
01
—
785552
UNITED CONCORDIA
—
Enumeration date
08/07/2006
Last updated
07/08/2007
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