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Individual

DR. GARY A WALL JR.

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
10627 19TH AVE SE, EVERETT, WA 98208-5147
(425) 337-6553
(425) 385-8943
Mailing address
10627 19TH AVE SE, EVERETT, WA 98208-5147
(425) 337-6553
(425) 385-8943

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
08241
WA

Other

Enumeration date
12/15/2005
Last updated
07/08/2007
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