MICHAEL JAMES WALLACE

GREEN BAY, WI
NPI1124127279
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: WI  2515)
Enumeration Date2006-09-22
Last Update Date2007-07-08
Business Address
Dr. MICHAEL JAMES WALLACE DDS
1195 W MASON ST
GREEN BAY, WI 54303-2045
Phone number: 920-498-3633
Mailing Address
Dr. MICHAEL JAMES WALLACE DDS
1195 W MASON ST
GREEN BAY, WI 54303-2045
Phone number: 920-498-3633