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1497216568
LISA MICHELLE WALLACE
ROCHESTER, NY
NPI
1497216568
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2019-03-29
Last Update Date
2019-03-29
Business Address
LISA MICHELLE WALLACE DDS
625 ELMWOOD AVE # 683
ROCHESTER, NY 14620-2913
Phone number: 585-275-8315
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Mailing Address
LISA MICHELLE WALLACE DDS
625 ELMWOOD AVE # 683
ROCHESTER, NY 14620-2913
Phone number: 585-275-8315
Copy
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