Organization
BIG SMILE DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARTER M WALLER DMD (DENTIST)
(540) 899-1777
Entity
Organization
Contact information
Practice address
1315 JEFFERSON DAVIS HWY, FREDERICKSBURG, VA 22401-4640
(540) 899-1777
(540) 899-2266
Mailing address
1315 JEFFERSON DAVIS HWY, FREDERICKSBURG, VA 22401-4640
(540) 899-1777
(540) 899-2266
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
0401410947
VA
261QD0000X
Dental Clinic/Center
0401415285
VA
Other
Enumeration date
07/18/2017
Last updated
07/21/2022
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