| NPI | 1306358312 |
|---|---|
| Other Name | CHERYL LYNN WALLACE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: MA DH89055) |
| Additional Taxonomies | 1223D0001X Dentist, Dental Public Health (Licence: AZ H009325) |
| Enumeration Date | 2017-10-31 |
| Last Update Date | 2026-01-13 |