Ashley Wallace, DMD

NPI #1417466236 in Groton, Connecticut

Provider Information

NPI Number: 1417466236
Entity Type: Individual
Name: Ashley Wallace, DMD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist - General Practice
Credential: DMD
Enumeration Date: Sep 25, 2017
Last Updated: Sep 25, 2017

Practice Location

Address: 1 WAHOO AVE
City: Groton
State: Connecticut
ZIP Code: 06349-2324
Phone: (860) 694-3738

Specialties & Taxonomy Codes

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

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