Dr. Charles Wallace, Dds, Ps
NPI #1962539114 in Seattle, Washington
Provider Information
- NPI Number
- 1962539114
- Entity Type
- Organization
- Organization Name
- Dr. Charles Wallace, Dds, Ps
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Feb 27, 2007
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 3221 EASTLAKE AVE E STE 130
- City
- Seattle
- State
- Washington
- ZIP Code
- 98102-7125
- Phone
- (206) 633-5100
Authorized Official
- Name
- DR. CHARLES E WALLACE, DDS
- Title
- OWNER
- Phone
- (206) 633-5100
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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