Provider Demographics
NPI:1376578161
Name:WALLS, WILLIAM HARVEY JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:HARVEY
Last Name:WALLS
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:656 INDEPENDENCE PKWY
Mailing Address - Street 2:SUITE #210
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-5213
Mailing Address - Country:US
Mailing Address - Phone:757-548-1919
Mailing Address - Fax:757-548-4492
Practice Address - Street 1:656 INDEPENDENCE PKWY
Practice Address - Street 2:SUITE 210
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-5213
Practice Address - Country:US
Practice Address - Phone:757-548-1919
Practice Address - Fax:757-548-4492
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0401007229122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist