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1437113479
MATT WALLACE
VENTURA, CA
NPI
1437113479
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: CA 48566)
Enumeration Date
2006-04-14
Last Update Date
2007-07-08
Business Address
Dr. MATT WALLACE
9290 TELEPHONE RD
VENTURA, CA 93004-2601
Phone number: 805-671-9697
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Mailing Address
Dr. MATT WALLACE
9290 TELEPHONE RD
VENTURA, CA 93004-2601
Phone number: 805-671-9697
Copy
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