Derek H. Wall DDS PA
NPI #1255563946 in Lynn Haven, Florida
Provider Information
- NPI Number
- 1255563946
- Entity Type
- Organization
- Organization Name
- Derek H. Wall DDS PA
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Aug 14, 2009
- Last Updated
- Aug 14, 2009
Practice Location
- Address
- 801 OHIO AVE
- City
- Lynn Haven
- State
- Florida
- ZIP Code
- 32444-2351
- Phone
- (850) 265-3696
Authorized Official
- Name
- DEREK HEATH WALL DDS PA
- Title
- PRESIDENT
- Phone
- (850) 265-3696
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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