Provider Demographics
NPI:1447366786
Name:YOUNG, WALTER LEE JR (DMD)
Entity type:Individual
Prefix:DR
First Name:WALTER
Middle Name:LEE
Last Name:YOUNG
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7001 HODGSON MEMORIAL DR. #3
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-2549
Mailing Address - Country:US
Mailing Address - Phone:912-352-2021
Mailing Address - Fax:912-354-7729
Practice Address - Street 1:7001 HODGSON MEMORIAL DR. #3
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-2549
Practice Address - Country:US
Practice Address - Phone:912-352-2021
Practice Address - Fax:912-354-7729
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGA102851223P0300X
GA102851223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics