Healthcare Provider Details

I. General information

NPI: 1326847567
Provider Name (Legal Business Name): AVA ELIZABETH WALCH DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2025
Last Update Date: 03/11/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 MICHIGAN AVE NW
WASHINGTON DC
20010-2916
US

IV. Provider business mailing address

57 PRINCETON BLVD
BUFFALO NY
14217-1715
US

V. Phone/Fax

Practice location:
  • Phone: 888-884-2327
  • Fax:
Mailing address:
  • Phone: 603-249-6249
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: