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
State
Georgia
ZIP Code
30458
Phone
(912) 764-6737

Specialties & Taxonomy Codes

Specialty
Dentist - Orthodontics and Dentofacial OrthopedicsOrthodontics and Dentofacial Orthopedics

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