Individual provider · Type 1 NPI
Eric Boles Wall, DDS
Oral and Maxillofacial Surgery (Dentist) · Stockton, CA
NPI number
1366479230
Active
Practice location
6529 Inglewood Ave, A-1
Stockton, CA 95207-3864
Fax (209) 473-2775
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) Primary | 1223S0112X | 26796 (CA) |
Oral and Maxillofacial Surgery (Dentist): The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
3 other providers at this address
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About NPI 1366479230
Eric Boles Wall, DDS's National Provider Identifier is 1366479230, issued on Jun 27, 2006. The primary taxonomy on file is Oral and Maxillofacial Surgery (Dentist) (1223S0112X), and the practice location is in Stockton, CA. The record was last updated on Jul 8, 2007.