Walter, Robert Douglas

Walter, Robert Douglas is an individual health care provider with primary practice located at 11092 Anderson Street Llu School Of Dentistry, Loma Linda CA 92350-0001. He recently has only one registered license in Dental Providers / Prosthodontics, which is considered as his primary health care specialty. Walter, Robert Douglas can be contacted via phone (909) 558-4613.

Contact Information

Primary practice address
11092 Anderson Street Llu School Of Dentistry Loma Linda CA 92350-0001
Phone: (909) 558-4613
Fax: (909) 558-4192
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Prosthodontics 1223P0700X 46444 California

Profile Details

NPI number 1376878918
LBN Legal business name Walter, Robert Douglas
Credentials DDS, MSD
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 15th, 2009
Last updated Oct 15th, 2009 - about 16 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 1376878918 NPPES
California Other 46444 STATE LICENSE

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