Wall, Timothy Raymond

Wall, Timothy Raymond is an sole proprietor health care provider with primary practice located at 250 Clark St , Pewaukee WI 53072-3529. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Wall, Timothy Raymond can be contacted via phone (262) 695-9392.

Contact Information

Primary practice address
250 Clark St Pewaukee WI 53072-3529
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 3951-015 Wisconsin

Profile Details

NPI number 1932255627
LBN Legal business name Wall, Timothy Raymond
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 26th, 2007
Last updated Jul 8th, 2007 - about 19 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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