DR. Douglas W. Wallace, D.D.S., M.S.

NPI #1376698753 in Fairfield, Ohio

Provider Information

NPI Number: 1376698753
Entity Type: Individual
Name: DR. Douglas W. Wallace, D.D.S., M.S.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Oral & Maxillofacial Surgery
Credential: D.D.S., M.S.
Enumeration Date: Jan 24, 2007
Last Updated: Apr 1, 2008

Practice Location

Address: 5188 WINTON RD
City: Fairfield
State: Ohio
ZIP Code: 45014-2900
Phone: (513) 829-8080

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Oral & Maxillofacial Surgery	204E00000X	Primary

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Organizations

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