DR. Michael James Wallace, DDS
NPI #1124127279 in Green Bay, Wisconsin
Provider Information
- NPI Number
- 1124127279
- Entity Type
- Individual
- Name
- DR. Michael James Wallace, DDS
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Dentist - General Practice
- Credential
- DDS
- Enumeration Date
- Sep 22, 2006
- Last Updated
- Jul 8, 2007
Practice Location
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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