Individual
BENJAMIN ROBERT WALDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS MS
Contact information
Practice address
301 TANGER DR, SUITE 225, TERRELL, TX 75160-6651
(972) 215-7645
Mailing address
301 TANGER DR, SUITE 225, TERRELL, TX 75160-6651
(310) 413-8899
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
24486
TX
Other
Enumeration date
06/06/2009
Last updated
11/02/2010
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