Provider Demographics
NPI:1841284411
Name:WALTON, JAMES LOWELL (DDS)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:LOWELL
Last Name:WALTON
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 1:212 STAR ST
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-4825
Mailing Address - Country:US
Mailing Address - Phone:507-387-4078
Mailing Address - Fax:507-387-4055
Practice Address - Street 1:212 STAR ST
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-4825
Practice Address - Country:US
Practice Address - Phone:507-387-4078
Practice Address - Fax:507-387-4055
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND81861223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry