| Shawn A. Walls, Dds, Pc | |
|
10700 Medlock Bridge Rd Suite 202 Johns Creek GA 30097-8456 | |
| (404) 444-8485 | |
| (770) 814-7407 |
| Full Name | Shawn A. Walls, Dds, Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 10700 Medlock Bridge Rd, Johns Creek, Georgia |
| Authorized Official Name and Position | Shawn A Walls (OWNER/CEO) |
| Authorized Official Contact | 4044448485 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shawn A. Walls, Dds, Pc 10700 Medlock Bridge Rd Suite 202 Johns Creek GA 30097-8456 Ph: (404) 444-8485 | Shawn A. Walls, Dds, Pc 10700 Medlock Bridge Rd Suite 202 Johns Creek GA 30097-8456 Ph: (404) 444-8485 |
| NPI Number | 1376929125 |
|---|---|
| Provider Enumeration Date | 08/04/2015 |
| Last Update Date | 08/04/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376929125 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 010715 (Georgia) | Primary |
| 1223G0001X | Dentist - General Practice | 9711 (Georgia) | Secondary |
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Shawn A. Walls, Dds, Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 10700 Medlock Bridge Rd., Suite 202, Johns Creek, GA 30097 Phone: 770-813-0079 Fax: 770-814-7407 | |
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