Individual
DR. LAURA G WALLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
533 WEST CHURCH STREET, BATESBURG, SC 29006
(803) 532-3331
(803) 532-3310
Mailing address
533 WEST CHURCH STREET, BATESBURG, SC 29006
(803) 532-3331
(803) 532-3310
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3590
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114140514
—
SC
05
—
ZA9578
—
SC
Enumeration date
08/09/2006
Last updated
08/22/2011
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