Provider Demographics
NPI:1861601684
Name:VUCHNICH, WALTER S (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:WALTER
Middle Name:S
Last Name:VUCHNICH
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1028 LEE ANN DR NE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-2903
Mailing Address - Country:US
Mailing Address - Phone:704-782-5146
Mailing Address - Fax:704-784-2002
Practice Address - Street 1:1028 LEE ANN DR NE
Practice Address - Street 2:SUITE 300
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-2903
Practice Address - Country:US
Practice Address - Phone:704-782-5146
Practice Address - Fax:704-784-2002
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC50601223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics