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1053428680
KENNETH LEE WALLACE
ARLINGTON, TX
NPI
1053428680
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: TX 14263)
Enumeration Date
2006-08-23
Last Update Date
2007-07-08
Business Address
Dr. KENNETH LEE WALLACE DDS
4226 LITTLE RD
ARLINGTON, TX 76016-5601
Phone number: 817-483-1133
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Mailing Address
Dr. KENNETH LEE WALLACE DDS
4226 LITTLE RD
ARLINGTON, TX 76016-5601
Phone number: 817-483-1133
Copy
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