John Dean Wallace JR. DDS

NPI 1629241070 - Dentist - 1223G0001X

NPI Details
NPI 1629241070
Gender Male
Enumeration Date 04/08/2008
Last Updated 04/08/2008
Entity Type Individual
Active Over 8 years ago
Practice Location
9913 MISSION GORGE RD UNIT 1
SANTEE CA, 92071-3843, US
Phone (619) 448-3214
Fax
Business Location
9913 MISSION GORGE RD UNIT 1
SANTEE CA, 92071-3843, US
Phone (619) 448-3214
Fax
Toxanomy
Taxonomy Code 1223G0001X
License State California
License Number 22186
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According to our database, Dr. John Dean Wallace JR. DDS NPI is 1629241070, taxonomy code is 1223G0001X and license number is 22186, license state is located at California. John Dean Wallace JR. DDS physically located at 9913 Mission Gorge Rd Unit 1, Santee CA, 92071-3843. NPI Number John Dean Wallace JR. DDS has the Individual type.

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1629241070 NPI number is provided on an as is basis without warranty of any kind. 1629241070 is maintained by the National Plan & Provider Enumeration System. The contents of John Dean Wallace JR. DDS are for informational purposes only.