Dr. Douglas R Wall, D.D.S.
Dentist in Long Beach, CA. Individual provider (NPI-1).
NPI number1467462002
StatusActive
Last updated in NPPESJun 30, 2008
Details
- NPI
- 1467462002
- Entity type
- Individual (NPI-1)
- Name
- Dr. Douglas R Wall
- Credential
- D.D.S.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 8, 2006
- Last updated
- Jun 30, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 31417 | CA | Yes |
Practice location
5479 E Abbeyfield St#4
Long Beach, CA 90815-3050
Phone 562-597-1414 · Fax 562-498-6174
Mailing address
5479 E Abbeyfield St# 4
Long Beach, CA 90815-3050
Phone 562-597-1414 · Fax 562-498-6174
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