ANDREA L WALLACE

EMMETT, ID
NPI1871608604
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: ID  D-3656)
Enumeration Date2006-08-20
Last Update Date2007-07-09
Business Address
Mrs. ANDREA L WALLACE D.M.D.
2003 S PLAZA RD
EMMETT, ID 83617-9180
Phone number: 208-365-3534
Mailing Address
Mrs. ANDREA L WALLACE D.M.D.
2003 S PLAZA RD
EMMETT, ID 83617-9180
Phone number: 208-365-3534
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