Provider Demographics
NPI:1447470059
Name:WALTHER, WILLIAM C (DDS)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:C
Last Name:WALTHER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:381 STUYVESANT ST
Mailing Address - Street 2:STE. 3
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20186-2400
Mailing Address - Country:US
Mailing Address - Phone:540-347-2233
Mailing Address - Fax:
Practice Address - Street 1:381 STUYVESANT ST
Practice Address - Street 2:STE. 3
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186-2400
Practice Address - Country:US
Practice Address - Phone:540-347-2233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010045101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice