DR. Jimmy Lee Wardlaw SR.

NPI #1154691434 in Rockwall, Texas

Provider Information

NPI Number: 1154691434
Entity Type: Individual
Name: DR. Jimmy Lee Wardlaw SR.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist
Enumeration Date: Jan 4, 2012
Last Updated: Jan 4, 2012

Practice Location

Address: 107 SCENIC DR
City: Rockwall
State: Texas
ZIP Code: 75032-8615
Phone: (972) 771-8602

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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