Individual provider · Type 1 NPI

Tanya C. Wall, DDS

Pediatric Dentistry · Jacksonville, FL

NPI number 1063528586 Active

Practice location

2255 Dunn Ave, Bldg. 700
Jacksonville, FL 32218

Call (904) 751-5126 Map

Fax (904) 751-5146

Mailing address

PO Box 26948
Jacksonville, FL 32226

Specialties and licenses

TaxonomyCodeLicense
Pediatric Dentistry Primary 1223P0221XDN15601 (FL)

Pediatric Dentistry: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.

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About NPI 1063528586

Tanya C. Wall, DDS's National Provider Identifier is 1063528586, issued on Aug 21, 2006. The primary taxonomy on file is Pediatric Dentistry (1223P0221X), and the practice location is in Jacksonville, FL. The record was last updated on Jan 8, 2019.