Organization
WALTHER DENTAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NEWELL A WALTHER D.D.S. (OWNER)
(907) 376-9449
Entity
Organization
Contact information
Practice address
1700 E BOGARD RD BLDG B, WASILLA, AK 99654-6563
(907) 376-9449
(907) 376-9339
Mailing address
1700 E BOGARD RD STE B204, WASILLA, AK 99654-6570
(907) 376-9449
(907) 376-9339
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1038
AK
122300000X
Dentist
1566
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003444
—
AK
05
—
1612641
—
AK
Enumeration date
05/07/2008
Last updated
04/21/2016
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