Provider Demographics
NPI:1861408031
Name:BARTON, WALTER WILLIAM III (DMD)
Entity type:Individual
Prefix:DR
First Name:WALTER
Middle Name:WILLIAM
Last Name:BARTON
Suffix:III
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2005 DEERFIELD WAY
Mailing Address - Street 2:
Mailing Address - City:TUNNEL HILL
Mailing Address - State:GA
Mailing Address - Zip Code:30755-8516
Mailing Address - Country:US
Mailing Address - Phone:706-673-3370
Mailing Address - Fax:
Practice Address - Street 1:1435 BROADRICK DR
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30720-3010
Practice Address - Country:US
Practice Address - Phone:706-226-3404
Practice Address - Fax:706-226-1615
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0129481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice