MR. Frederick Otto Wallace III, DDS
NPI #1538261789 in Solana Beach, California
Provider Information
- NPI Number
- 1538261789
- Entity Type
- Individual
- Name
- MR. Frederick Otto Wallace III, DDS
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Dentist
- Credential
- DDS
- Enumeration Date
- Sep 1, 2006
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 530 LOMAS SANTA FE
- Address 2
- SUITE #7
- City
- Solana Beach
- State
- California
- ZIP Code
- 92075
- Phone
- (858) 755-2414
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist |
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