Charles C Wall DDS

NPI #1306060306 in Salt Lake City, Utah

Provider Information

NPI Number
1306060306
Entity Type
Organization
Organization Name
Charles C Wall DDS
Primary Specialty
Dentist - General Practice
Enumeration Date
Apr 12, 2007
Last Updated
Jul 22, 2008

Practice Location

Address
2200 EAST 4500 SOUTH
Address 2
SUITE 240
State
Utah
ZIP Code
84117
Phone
(801) 278-3864

Authorized Official

Name
DR. CHARLES C WALL, DDS
Title
OWNER
Phone
(801) 278-3864

Specialties & Taxonomy Codes

Specialty
Dentist - General PracticeGeneral Practice

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