Provider Demographics
NPI:1730254657
Name:WALKUP, DANIEL HOWARD (DMD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:HOWARD
Last Name:WALKUP
Suffix:
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 1:1630 S.E. 18TH STREET - BLDG #500
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471
Mailing Address - Country:US
Mailing Address - Phone:352-690-3009
Mailing Address - Fax:352-690-6084
Practice Address - Street 1:1630 S.E. 18TH STREET - BLDG #500
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471
Practice Address - Country:US
Practice Address - Phone:352-690-3009
Practice Address - Fax:352-690-6084
Is Sole Proprietor?:No
Enumeration Date:2006-11-24
Last Update Date:2013-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0012430122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist