Charles Coleman Wall, DDS
NPI #1376985655 in Salt Lake City, Utah
Provider Information
- NPI Number
- 1376985655
- Entity Type
- Individual
- Name
- Charles Coleman Wall, DDS
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Dentist
- Credential
- DDS
- Enumeration Date
- Jul 26, 2013
- Last Updated
- Jul 26, 2013
Practice Location
- Address
- 2200 E 4500 S
- Address 2
- SUITE 240
- City
- Salt Lake City
- State
- Utah
- ZIP Code
- 84117-4437
- Phone
- (801) 278-3864
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist |
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