MICHAEL J WALLACE

EDMOND, OK
NPI1417014424
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy122300000X Dentist
(Licence: OK  5801)
Enumeration Date2007-01-02
Last Update Date2021-01-28
Business Address
Dr. MICHAEL J WALLACE DDS
1617 E DANFORTH RD
EDMOND, OK 73034-3103
Phone number: 405-340-0411
Mailing Address
Dr. MICHAEL J WALLACE DDS
1617 E DANFORTH ROAD
EDMOND, OK 73034-6622
Phone number: 405-340-0411
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