Kenneth Lee Wallace DDS

NPI 1053428680 - Dentist - 1223G0001X

NPI Details
NPI 1053428680
Gender Male
Enumeration Date 08/23/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
4226 LITTLE RD
ARLINGTON TX, 76016-5601, US
Phone (817) 483-1133
Fax (817) 483-0388
Business Location
4226 LITTLE RD
ARLINGTON TX, 76016-5601, US
Phone (817) 483-1133
Fax (817) 483-0388
Toxanomy
Taxonomy Code 1223G0001X
License State Texas
License Number 14263
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According to our database, Dr. Kenneth Lee Wallace DDS NPI is 1053428680, taxonomy code is 1223G0001X and license number is 14263, license state is located at Texas. Kenneth Lee Wallace DDS physically located at 4226 Little Rd, Arlington TX, 76016-5601. NPI Number Kenneth Lee Wallace DDS has the Individual type.

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1053428680 NPI number is provided on an as is basis without warranty of any kind. 1053428680 is maintained by the National Plan & Provider Enumeration System. The contents of Kenneth Lee Wallace DDS are for informational purposes only.