| NPI | 1346360765 |
|---|---|
| Former Legal Business Name | SCOTT WALLACE DDS, LLC |
| Entity Type | Organization |
| Authorized Contact | JAMES W WOLITARSKY Owner 610-286-5841 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS026093L) |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2020-03-07 |