DR. Jody Paul Wallace, D.D.S.
NPI #1740210103 in Graham, North Carolina
Provider Information
- NPI Number
- 1740210103
- Entity Type
- Individual
- Name
- DR. Jody Paul Wallace, D.D.S.
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Dentist - General Practice
- Credential
- D.D.S.
- Enumeration Date
- Jul 3, 2006
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 2148 HIGHWAY 54
- City
- Graham
- State
- North Carolina
- ZIP Code
- 27253
- Phone
- (336) 578-3884
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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