Provider Demographics
NPI:1457405292
Name:WALCH, VERONICA S (DDS)
Entity Type:Individual
Prefix:DR
First Name:VERONICA
Middle Name:S
Last Name:WALCH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 TUCKER RD STE I
Mailing Address - Street 2:
Mailing Address - City:TEHACHAPI
Mailing Address - State:CA
Mailing Address - Zip Code:93561-2565
Mailing Address - Country:US
Mailing Address - Phone:661-822-1333
Mailing Address - Fax:661-822-3313
Practice Address - Street 1:840 TUCKER RD
Practice Address - Street 2:SUITE I
Practice Address - City:TEHACHAPI
Practice Address - State:CA
Practice Address - Zip Code:93561-2564
Practice Address - Country:US
Practice Address - Phone:661-822-1333
Practice Address - Fax:661-822-3313
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2008-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA509871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice