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DR. JAY M WALTERS D.D.S.
General Practice >> Dentist >> Dental ProvidersRegistrant NPI Number: 1881782670
Individual Registrant:DR. JAY M WALTERS D.D.S.
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
526 N DALEVILLE AVE DALEVILLE, AL 36322-2000 US
Tel: 334-598-4994 Fax: --
Tel: 334-598-4994 Fax: --
Contact information for business:
526 N DALEVILLE AVE DALEVILLE, AL 36322-2000 US
Tel: 334-598-4994 Fax: --
Tel: 334-598-4994 Fax: --
Registration Information:
NPI: 1881782670
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 1223G0001X | Dental Providers Dentist General Practice | AL | 4553 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 380241 | AL | 05 | |
| UCCI | 820510 | AL | 01 |
| BCBS | 515-25448 | AL | 01 |
