OSCAR RUSSELL WALLACE

CUMMING, GA
NPI1215722509
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: GA  DN123883)
Enumeration Date2025-04-09
Last Update Date2025-09-17
Business Address
OSCAR RUSSELL WALLACE
312 TRIBBLE GAP RD
CUMMING, GA 30040-2440
Phone number: 770-887-1399
Mailing Address
OSCAR RUSSELL WALLACE
2545 PINE BLUFF DR
DECATUR, GA 30033-4927
Phone number: 404-723-0281
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