Provider Demographics
NPI:1356721807
Name:WALTERS, ERIC (DDS)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:
Last Name:WALTERS
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 1:200 N LA CUMBRE RD
Mailing Address - Street 2:SUITE H
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93110-1577
Mailing Address - Country:US
Mailing Address - Phone:805-755-4737
Mailing Address - Fax:805-687-3415
Practice Address - Street 1:200 N LA CUMBRE RD
Practice Address - Street 2:SUITE H
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93110-1577
Practice Address - Country:US
Practice Address - Phone:805-755-4737
Practice Address - Fax:805-687-3415
Is Sole Proprietor?:No
Enumeration Date:2015-05-30
Last Update Date:2015-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA63695122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist