LESLIE SUZANNE WALLACE

LEBANON, TN
NPI1629301833
Former NameLESLIE SUZANNE PARHAM
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy1223P0221X Dentist, Pediatric Dentistry
(Licence: TN  8973)
Enumeration Date2009-09-08
Last Update Date2014-01-08
Business Address
-- LESLIE SUZANNE WALLACE DMD
103 PHYSICIANS WAY SUITE 150
LEBANON, TN 37090-4104
Phone number: 859-948-0386
Mailing Address
-- LESLIE SUZANNE WALLACE DMD
179 COBBLER CIR
HENDERSONVILLE, TN 37075-3963
Phone number: 859-948-0386