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1093569204
BRANDON TOBIAS WALLACE
CINCINNATI, OH
NPI
1093569204
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2024-04-15
Last Update Date
2024-04-15
Business Address
Dr. BRANDON TOBIAS WALLACE DMD
4605 E GALBRAITH RD STE 100
CINCINNATI, OH 45236-2888
Phone number: 513-961-1991
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Mailing Address
Dr. BRANDON TOBIAS WALLACE DMD
345 HARRISON AVE PH 19
BOSTON, MA 02118-4095
Phone number: 910-580-5699
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