Larry Walton

NPI 1063440311 · on the registry since 2006 · sole proprietor

Practice

Address: 1220 West Milham Ave
Portage, MI 49024
Phone: (269) 382-9900
Fax: (269) 382-0700
Organisation at this address: Larry R Walton
Portage Northern Dental
Inferred from a shared address, not stated in the registry.

Registry record

Primary taxonomy: 174400000X
174400000X
Also registered as: 335E00000X
Licence states on file: MI
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2011-08-11

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Michigan