Provider Demographics
NPI:1003886995
Name:WALTON, DAVID KIMBALL (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:KIMBALL
Last Name:WALTON
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4026 S TIMBERLINE RD UNIT 120
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-6024
Mailing Address - Country:US
Mailing Address - Phone:970-482-2210
Mailing Address - Fax:970-482-2208
Practice Address - Street 1:4026 S TIMBERLINE RD UNIT 120
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-6024
Practice Address - Country:US
Practice Address - Phone:970-482-2210
Practice Address - Fax:970-482-2208
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO90311223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics