DR. Michael Shane Wall, D.M.D.
NPI #1396842589 in Statesboro, Georgia
Provider Information
- NPI Number
- 1396842589
- Entity Type
- Individual
- Name
- DR. Michael Shane Wall, D.M.D.
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Dentist - Orthodontics and Dentofacial Orthopedics
- Credential
- D.M.D.
- Enumeration Date
- Sep 20, 2006
- Last Updated
- Dec 14, 2009
Practice Location
- Address
- 506 GENTILLY ROAD
- City
- Statesboro
- State
- Georgia
- ZIP Code
- 30458
- Phone
- (912) 764-6737
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Orthodontics and Dentofacial Orthopedics — Orthodontics and Dentofacial Orthopedics |
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