Individual provider · Type 1 NPI

Walter Cooper Sandusky Iii, DDS, MS

Orthodontics and Dentofacial Orthopedics Dentistry · Memphis, TN

NPI number 1780722959 Active

Practice location

6262 Poplar Ave
Memphis, TN 38119-4728

Fax (901) 680-0403

Specialties and licenses

Taxonomy	Code	License
Orthodontics and Dentofacial Orthopedics Dentistry Primary	1223X0400X	3809 (TN)

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…

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About NPI 1780722959

Walter Cooper Sandusky Iii, DDS, MS's National Provider Identifier is 1780722959, issued on Feb 1, 2007. The primary taxonomy on file is Orthodontics and Dentofacial Orthopedics Dentistry (1223X0400X), and the practice location is in Memphis, TN. The record was last updated on Jul 8, 2007.