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1083759930
PHILLIP WENDELL WALLACE
WILLOUGHBY, OH
NPI
1083759930
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: OH 16266)
Enumeration Date
2007-02-20
Last Update Date
2007-07-08
Business Address
-- PHILLIP WENDELL WALLACE D.D.S.
36001 EUCLID AVE STE A15
WILLOUGHBY, OH 44094-4643
Phone number: 440-946-5484
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Mailing Address
-- PHILLIP WENDELL WALLACE D.D.S.
36001 EUCLID AVE STE A15
WILLOUGHBY, OH 44094-4643
Phone number: 440-946-5484
Copy
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