C.M. WALLACE

BONITA SPRINGS, FL
NPI1487085072
Professional NameCHARLES MACON WALLACE
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1223G0001X Dentist General Practice
(Licence: FL  DN14024)
Enumeration Date2013-12-06
Last Update Date2013-12-06
Business Address
C.M. WALLACE DDS
8951 BONITA BEACH RD SE STE 206
BONITA SPRINGS, FL 34135-4202
Phone number: 239-992-8555
Mailing Address
C.M. WALLACE DDS
8951 BONITA BEACH RD SE STE 206
BONITA SPRINGS, FL 34135-4202
Phone number: 239-992-8555
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BONITA SPRINGS EDC MANAGEMENT LLC