Individual
RANDY P WALTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
632 W FRONT ST N, THOMASVILLE, AL 36784-5316
(334) 636-2713
(334) 636-2711
Mailing address
632 W FRONT ST N, THOMASVILLE, AL 36784-5316
(334) 636-2713
(334) 636-2711
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
149
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009943710
—
AL
Enumeration date
09/25/2006
Last updated
10/20/2009
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