Individual
DR. CARL PAUL WALTKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
180 OLD TAPPAN RD, OLD TAPPAN, NJ 07675-7052
(201) 767-4001
(201) 767-4632
Mailing address
180 OLD TAPPAN RD, OLD TAPPAN, NJ 07675-7052
(201) 767-4001
(201) 767-4632
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
16438
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200025
AETNA US HEALTH CARE
NJ
Enumeration date
11/02/2006
Last updated
07/08/2007
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