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Ian Wall
General Practice Dentistry in New York, New York
NPI 1659950061

Ian Wall is a General Practice Dentistry based in Sayville, NY and is specialized in General Practice. Ian Wall practices in New York, NY. The NPI Number for Ian Wall is 1659950061 and holds a License No. (New York).

The current practice location address for Ian Wall is 180 Fort Washington Ave, New York, NY and can be reached out via phone at 212-305-7626.

Location: 180 Fort Washington Ave, New York, NY, 11782-2420
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1659950061
Provider Name
Ian Wall
Credential
Provider Entity Type
Individual
Gender
Male
Address
180 Fort Washington Ave, New York, NY, 11782-2420
Phone Number
212-305-7626
Fax Number
Provider Enumeration Date
04/04/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
180 Fort Washington Ave
City
New York
State
New York
Zip
10032-3722
Phone Number
212-305-7626
Fax Number
person
Provider Business Mailing Address Details
Address
180 Fort Washington Ave
City
New York
State
New York
Zip
10032-3722
Phone Number
212-305-7626
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
0401417767 (Virginia)
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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