| Shawn R Walton | |
|
2928 Hamilton Blvd Suite 102 Sioux City IA 51104 | |
| (712) 255-7607 | |
| (712) 255-4507 |
| Full Name | Shawn R Walton |
|---|---|
| Speciality | Dentist |
| Location | 2928 Hamilton Blvd, Sioux City, Iowa |
| Authorized Official Name and Position | Shawn R Walton (DENTIST) |
| Authorized Official Contact | 7122557607 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shawn R Walton 2928 Hamilton Blvd Suite 102 Sioux City IA 51104 Ph: (712) 255-7607 | Shawn R Walton 2928 Hamilton Blvd Suite 102 Sioux City IA 51104 Ph: (712) 255-7607 |
| NPI Number | 1659482206 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659482206 | NPI | - | NPPES |
| 10025415600 | Medicaid | NE | |
| 0102343 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 07610 (Iowa) | Primary |
| 122300000X | Dentist | 08441 (Iowa) | Secondary |
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