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General NPI Number Information
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NPI Number | 1861408031
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Entity Type | Individual
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Provider Name | WALTER WILLIAM BARTON III D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 08/13/2007
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Provider Practice Location Address
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Address Line | 1435 BROADRICK DR
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City | DALTON
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State | GA
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Zip | 30720-3010
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Country | US
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Telephone | 706-226-3404
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Fax | 706-226-1615
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Provider Business Mailing Address
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Address Line | 2005 DEERFIELD WAY
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City | TUNNEL HILL
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State | GA
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Zip | 30755-8516
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Country | US
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Telephone | 706-673-3370
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN012948
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License Number State | GA
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