JASON WALLACE

EDMOND, OK
NPI1346698842
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: OK  6806)
Enumeration Date2016-05-25
Last Update Date2016-05-25
Business Address
Dr. JASON WALLACE D.D.S.
1400 W COVELL RD
EDMOND, OK 73003-3504
Phone number: 405-348-6161
Mailing Address
Dr. JASON WALLACE D.D.S.
1400 W COVELL RD
EDMOND, OK 73003-3504
Phone number:
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