Provider Demographics
NPI:1720040496
Name:INGE, WALTER HERMAN JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:WALTER
Middle Name:HERMAN
Last Name:INGE
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 533
Mailing Address - Street 2:
Mailing Address - City:JARRETTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21084-0533
Mailing Address - Country:US
Mailing Address - Phone:410-605-7058
Mailing Address - Fax:410-605-7819
Practice Address - Street 1:10 N GREENE ST
Practice Address - Street 2:VETERANS HOSPITAL
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1524
Practice Address - Country:US
Practice Address - Phone:410-605-7058
Practice Address - Fax:410-605-7819
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401006111122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist