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1407916877
BEN JAMES WALLACE
CHICAGO, IL
NPI
1407916877
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
122300000X Dentist
(Licence: IL 019024186)
Enumeration Date
2006-12-08
Last Update Date
2007-07-08
Business Address
Dr. BEN JAMES WALLACE D.D.S.
110 E 79TH ST
CHICAGO, IL 60619-2302
Phone number: 773-488-6000
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Mailing Address
Dr. BEN JAMES WALLACE D.D.S.
225 MORAY CT
CRETE, IL 60417-1127
Phone number: 708-757-3963
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