DR. Jason Wallace, D.D.S.

NPI #1346698842 in Edmond, Oklahoma

Provider Information

NPI Number
1346698842
Entity Type
Individual
Name
DR. Jason Wallace, D.D.S.
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Dentist - General Practice
Credential
D.D.S.
Enumeration Date
May 25, 2016
Last Updated
May 25, 2016

Practice Location

Address
1400 W COVELL RD
City
Edmond
ZIP Code
73003-3504
Phone
(405) 348-6161

Specialties & Taxonomy Codes

Specialty
Dentist - General PracticeGeneral Practice

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