DR. John Dean Wallace JR., DDS

NPI #1629241070 in Santee, California

Provider Information

NPI Number: 1629241070
Entity Type: Individual
Name: DR. John Dean Wallace JR., DDS
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist - General Practice
Credential: DDS
Enumeration Date: Apr 8, 2008
Last Updated: Apr 8, 2008

Practice Location

Address: 9913 MISSION GORGE RD UNIT 1
City: Santee
State: California
ZIP Code: 92071-3843
Phone: (619) 448-3214

Specialties & Taxonomy Codes

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

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