Phillip Wendell Wallace, D.D.S.
NPI #1083759930 in Willoughby, Ohio
Provider Information
- NPI Number
- 1083759930
- Entity Type
- Individual
- Name
- Phillip Wendell Wallace, D.D.S.
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Dentist - General Practice
- Credential
- D.D.S.
- Enumeration Date
- Feb 20, 2007
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 36001 EUCLID AVE STE A15
- City
- Willoughby
- State
- Ohio
- ZIP Code
- 44094-4643
- Phone
- (440) 946-5484
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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