Provider Demographics
NPI:1780932905
Name:WALTER C DUKES DDS A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:WALTER C DUKES DDS A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:C
Authorized Official - Last Name:DUKES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:805-963-1222
Mailing Address - Street 1:1809 CLIFF DR
Mailing Address - Street 2:SUITE D
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93109-1641
Mailing Address - Country:US
Mailing Address - Phone:805-963-1222
Mailing Address - Fax:805-730-9224
Practice Address - Street 1:1809 CLIFF DR
Practice Address - Street 2:SUITE D
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93109-1641
Practice Address - Country:US
Practice Address - Phone:805-963-1222
Practice Address - Fax:805-730-9224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-20
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA274261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty