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1972750909
KEVIN D WALLACE
SPRINGFIELD, MO
NPI
1972750909
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223P0700X Dentist Prosthodontics
(Licence: MO 014935)
Enumeration Date
2008-08-21
Last Update Date
2008-08-21
Business Address
DR. KEVIN D WALLACE DMD PC
1200 E WOODHURST DR STE A200
SPRINGFIELD, MO 65804-3745
Phone number: 417-881-1123
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Mailing Address
DR. KEVIN D WALLACE DMD PC
1200 E WOODHURST DR STE A200
SPRINGFIELD, MO 65804-3745
Phone number: 417-881-1123
Copy
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