DR. Nancy Smith Wallace, D.M.D.

NPI #1144341876 in Waukegan, Illinois

Provider Information

NPI Number: 1144341876
Entity Type: Individual
Name: DR. Nancy Smith Wallace, D.M.D.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist - General Practice
Credential: D.M.D.
Enumeration Date: Apr 2, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 1709 WASHINGTON ST
City: Waukegan
State: Illinois
ZIP Code: 60085-5133
Phone: (847) 662-6080

Specialties & Taxonomy Codes

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

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