Provider Demographics
NPI:1558573816
Name:FINKEN, WALTER M JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:WALTER
Middle Name:M
Last Name:FINKEN
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:WALTER
Other - Middle Name:M
Other - Last Name:FINKEN
Other - Suffix:JR
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:529 S NEW YORK RD
Mailing Address - Street 2:
Mailing Address - City:GALLOWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08205-9764
Mailing Address - Country:US
Mailing Address - Phone:609-652-9020
Mailing Address - Fax:
Practice Address - Street 1:529 S NEW YORK RD
Practice Address - Street 2:
Practice Address - City:GALLOWAY
Practice Address - State:NJ
Practice Address - Zip Code:08205-9764
Practice Address - Country:US
Practice Address - Phone:609-652-9020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ132121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ838817OtherPROVIDER ID UCCI