Individual provider · Type 1 NPI
Michael Shane Wall, DMD
Orthodontics and Dentofacial Orthopedics Dentistry · Statesboro, GA
Practice location
506 Gentilly Road
Statesboro, GA 30458
Fax (912) 489-4848
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry Primary | 1223X0400X | DN012729 (GA) |
Orthodontics and Dentofacial Orthopedics Dentistry: That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of funct…
Other orthodontics and dentofacial orthopedics dentistry providers in Statesboro
About NPI 1396842589
Michael Shane Wall, DMD's National Provider Identifier is 1396842589, issued on Sep 20, 2006. The primary taxonomy on file is Orthodontics and Dentofacial Orthopedics Dentistry (1223X0400X), and the practice location is in Statesboro, GA. The record was last updated on Dec 14, 2009.