Phillip W Wallace DDS INC
NPI #1699140202 in Willoughby, Ohio
Provider Information
- NPI Number
- 1699140202
- Entity Type
- Organization
- Organization Name
- Phillip W Wallace DDS INC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Dec 8, 2015
- Last Updated
- Dec 8, 2015
Practice Location
- Address
- 36001 EUCLID AVE
- Address 2
- SUITE A-15
- City
- Willoughby
- State
- Ohio
- ZIP Code
- 44094-4643
- Phone
- (440) 946-5485
Authorized Official
- Name
- DR. PHILLIP W WALLACE, DDS
- Title
- OWNER
- Phone
- (440) 946-5484
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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