Provider Demographics
NPI:1952483257
Name:WALTON, GRANT D (DMD)
Entity Type:Individual
Prefix:DR
First Name:GRANT
Middle Name:D
Last Name:WALTON
Suffix:
Gender:M
Credentials:DMD
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Mailing Address - Street 1:1187 E COTTONWOOD LN
Mailing Address - Street 2:SUITE A
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85222-2957
Mailing Address - Country:US
Mailing Address - Phone:520-421-1441
Mailing Address - Fax:520-421-1424
Practice Address - Street 1:1187 E COTTONWOOD LN
Practice Address - Street 2:SUITE A
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85222-2957
Practice Address - Country:US
Practice Address - Phone:520-421-1441
Practice Address - Fax:520-421-1424
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ41611223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics