| NPI | 1144706581 |
|---|---|
| Doing Business As | WALLACE FAMILY DENTAL |
| Entity Type | Organization |
| Authorized Contact | ZACHARY D WALLACE Owner 417-209-0972 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: AR 4241) |
| Enumeration Date | 2018-07-18 |
| Last Update Date | 2022-09-14 |