Provider Demographics
NPI:1578796637
Name:WALKER, DEVIN G (DDS)
Entity Type:Individual
Prefix:DR
First Name:DEVIN
Middle Name:G
Last Name:WALKER
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 1:1323 2ND AVE N
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58203-3427
Mailing Address - Country:US
Mailing Address - Phone:701-775-4289
Mailing Address - Fax:701-775-9596
Practice Address - Street 1:104 RIVERWOOD DR
Practice Address - Street 2:
Practice Address - City:HARWOOD
Practice Address - State:ND
Practice Address - Zip Code:58042-4020
Practice Address - Country:US
Practice Address - Phone:701-729-8900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-24
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND22501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice