KEVIN BRUCE WALLACE

LEESBURG, FL
NPI1316960131
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy122300000X Dentist
(Licence: FL  DN15774)
Enumeration Date2006-07-25
Last Update Date2011-11-02
Business Address
Dr. KEVIN BRUCE WALLACE D.M.D.
949 N 14TH ST
LEESBURG, FL 34748-3838
Phone number: 352-816-0855
Mailing Address
Dr. KEVIN BRUCE WALLACE D.M.D.
1107 S.E. 24 TERRACE
OCALA, FL 34471
Phone number: 352-867-9890
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