Wallace Edward Brunson JR. DDS

NPI 1093883936 - Dentist - 1223G0001X

NPI Details
NPI 1093883936
Gender Male
Enumeration Date 11/30/2006
Last Updated 09/04/2015
Entity Type Individual
Active Over 10 years ago
Practice Location
1314 CHARDONNAY DR
HOUSTON TX, 77077-3102, US
Phone (505) 690-9881
Fax
Business Location
1314 CHARDONNAY DR
HOUSTON TX, 77077-3102, US
Phone (505) 690-9881
Fax (505) 988-7667
Toxanomy
Taxonomy Code 1223G0001X
License State New Mexico
License Number NM1827
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According to our database, Dr. Wallace Edward Brunson JR. DDS NPI is 1093883936, taxonomy code is 1223G0001X and license number is NM1827, license state is located at New Mexico. Wallace Edward Brunson JR. DDS physically located at 1314 Chardonnay Dr, Houston TX, 77077-3102. NPI Number Wallace Edward Brunson JR. DDS has the Individual type.

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1093883936 NPI number is provided on an as is basis without warranty of any kind. 1093883936 is maintained by the National Plan & Provider Enumeration System. The contents of Wallace Edward Brunson JR. DDS are for informational purposes only.