Organization
GEORGE J WALTERS DDS PA
Active
Other names
George J Walters DDS PA
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE J WALTERS D.D.S. (PRESIDENT)
(850) 763-8585
Entity
Organization
Contact information
Practice address
2202 STATE AVE, SUITE 200, PANAMA CITY, FL 32405-7601
(850) 763-8585
(850) 763-3920
Mailing address
2202 STATE AVE, SUITE 200, PANAMA CITY, FL 32405-7601
(850) 763-8585
(850) 763-3920
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
DN0012432
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
073701101
—
FL
Enumeration date
02/20/2012
Last updated
02/23/2012
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