| Dr. Todd W. Walters P.c. | |
|
800 Fulton St Ste 4a Logansport IN 46947-1579 | |
| (574) 722-5313 | |
| (574) 753-3025 |
| Full Name | Dr. Todd W. Walters P.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 800 Fulton St Ste 4a, Logansport, Indiana |
| Authorized Official Name and Position | Todd Wayne Walters (PRESIDENT -OWNER) |
| Authorized Official Contact | 5747225313 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Todd W. Walters P.c. 800 Fulton St Ste 4a Logansport IN 46947-1579 Ph: (574) 722-5313 | Dr. Todd W. Walters P.c. 800 Fulton St Ste 4a Logansport IN 46947-1579 Ph: (574) 722-5313 |
| NPI Number | 1760568307 |
|---|---|
| Provider Enumeration Date | 10/27/2006 |
| Last Update Date | 02/25/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760568307 | NPI | - | NPPES |
| 100070910 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 12008831 (Indiana) | Primary |
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