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1508857053
PATRICK L WALLACE
ARDMORE, OK
NPI
1508857053
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223S0112X Dentist, Oral and Maxillofacial Surgery
(Licence: OK 4988)
Enumeration Date
2005-11-03
Last Update Date
2014-01-13
Business Address
Dr. PATRICK L WALLACE D.D.S.
1119 WALNUT DR SUITE 2
ARDMORE, OK 73401-2360
Phone number: 580-226-1727
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Mailing Address
Dr. PATRICK L WALLACE D.D.S.
PO BOX 108816
OKLAHOMA CITY, OK 73101-8816
Phone number: 405-848-7974
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