Provider Demographics
NPI:1023219078
Name:WALL, STERLING (DDS)
Entity Type:Individual
Prefix:DR
First Name:STERLING
Middle Name:
Last Name:WALL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6520 N 7TH AVE
Mailing Address - Street 2:SUITE #5
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013-1158
Mailing Address - Country:US
Mailing Address - Phone:602-242-2588
Mailing Address - Fax:602-242-3137
Practice Address - Street 1:6520 N 7TH AVE
Practice Address - Street 2:SUITE #5
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-1158
Practice Address - Country:US
Practice Address - Phone:602-242-2588
Practice Address - Fax:602-242-3137
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD49961223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics