Provider Demographics
NPI:1801004940
Name:WALKER, DANIEL B (DDS)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:B
Last Name:WALKER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3700 BELLEMEADE AVE
Mailing Address - Street 2:MEDICAL ARTS BLDG, SUITE 206
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47714-0102
Mailing Address - Country:US
Mailing Address - Phone:812-476-3522
Mailing Address - Fax:812-476-3522
Practice Address - Street 1:3700 BELLEMEADE AVE
Practice Address - Street 2:MEDICAL ARTS BLDG, SUITE 206
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47714-0102
Practice Address - Country:US
Practice Address - Phone:812-476-3522
Practice Address - Fax:812-476-3522
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN120088301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice