Kirk Jr, Walter Charles

Kirk Jr, Walter Charles is an individual health care provider with primary practice located at 1213 N Main St , Fuquay Varina NC 27526-2616. She recently has only one registered license in Dental Providers / Periodontics, which is considered as her primary health care specialty. Kirk Jr, Walter Charles can be contacted via phone (919) 552-9711.

Contact Information

Primary practice address
1213 N Main St Fuquay Varina NC 27526-2616
Phone: (919) 552-9711
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Periodontics 1223P0300X 6745 North Carolina

Profile Details

NPI number 1457403156
LBN Legal business name Kirk Jr, Walter Charles
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 16th, 2007
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457403156 NPPES
North Carolina MEDICAID 8990142

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