Basic Information
| Provider Information | |||||||||
| NPI: | 1003144346 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WALKER | ||||||||
| FirstName: | ALAN | ||||||||
| MiddleName: | DAVID | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.D.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 604 COUNTRY CLUB RD | ||||||||
| Address2: | |||||||||
| City: | HAVRE DE GRACE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210782103 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2022309947 | ||||||||
| FaxNumber: | 4103066132 | ||||||||
| Practice Location | |||||||||
| Address1: | 2270 VALOR DR | ||||||||
| Address2: | |||||||||
| City: | WINCHESTER | ||||||||
| State: | VA | ||||||||
| PostalCode: | 226013699 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5405457878 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/25/2009 | ||||||||
| LastUpdateDate: | 03/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 03/21/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223G0001X | 14671 | MD | N | Dental Providers | Dentist | General Practice | 1223G0001X | 0401413033 | VA | Y | Dental Providers | Dentist | General Practice |
No ID Information.