Leslie H Wallace, DR

NPI #1114171667 in Camp Pendleton, California

Provider Information

NPI Number: 1114171667
Entity Type: Individual
Name: Leslie H Wallace, DR
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist - General Practice
Credential: DR
Enumeration Date: Nov 11, 2008
Last Updated: Nov 11, 2008

Practice Location

Address: NAVAL HOSPITAL
Address 2: SANTA MARGARITA ROAD
City: Camp Pendleton
State: California
ZIP Code: 92055
Phone: (760) 725-8882

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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