DR. Charles E Wallace, DDS
NPI #1063584746 in Seattle, Washington
Provider Information
- NPI Number
- 1063584746
- Entity Type
- Individual
- Name
- DR. Charles E Wallace, DDS
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Dentist - General Practice
- Credential
- DDS
- Enumeration Date
- Nov 15, 2006
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 3221 EASTLAKE AVE E STE 130
- City
- Seattle
- State
- Washington
- ZIP Code
- 98102-7125
- Phone
- (206) 633-5100
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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