R Jeffrey Wallace DDS Pllc

NPI #1538201454 in Seymour, Tennessee

Provider Information

NPI Number: 1538201454
Entity Type: Organization
Organization Name: R Jeffrey Wallace DDS Pllc
Primary Specialty: Dentist - General Practice
Enumeration Date: Feb 14, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 111 PEACOCK COURT
City: Seymour
State: Tennessee
ZIP Code: 37865
Phone: (865) 577-0194

Authorized Official

Name: DR. R JEFFREY WALLACE, DDS
Title: OWNER PRESIDENT
Phone: (865) 577-0194

Specialties & Taxonomy Codes

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

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