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General NPI Number Information
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NPI Number | 1417383761
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Entity Type | Organization
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Legal Business Name | S. DESIREE WALKER, DDS, PA
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Dates
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Enumeration Date | 09/18/2013
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Last Update Date | 10/03/2013
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Provider Practice Location Address
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Address Line | 3718 HILLCREST DR
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City | LUMBERTON
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State | NC
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Zip | 28358
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Country | US
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Telephone | 919-360-7226
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Fax |
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Provider Business Mailing Address
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Address Line | 219 CHARMANT RD
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City | LUMBERTON
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State | NC
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Zip | 28358-2131
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Country | US
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Telephone | 910-474-2587
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Fax |
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Authorized Official
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Title or Position | DENTIST/BUSINESS OWNER
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Name | DR. SARAH DESIREE WALKER
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Credential | DDS
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Telephone | 910-474-2587
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 8588
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License Number State | NC
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