MARQUITA DIANE WALLACE

COVINGTON, LA
NPI1598087900
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy122300000X Dentist
(Licence: LA  6135)
Enumeration Date2010-02-26
Last Update Date2013-09-25
Business Address
Ms. MARQUITA DIANE WALLACE
600 N HIGHWAY 190 SUITE 4
COVINGTON, LA 70433-5003
Phone number: 615-887-1379
Mailing Address
Ms. MARQUITA DIANE WALLACE
600 N HIGHWAY 190 SUITE 4
COVINGTON, LA 70433-5003
Phone number: 615-887-1379