Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. MARSHALL LYNN WALLACE, DMD
ActiveDR. MARSHALL LYNN WALLACE, DMD is a Periodontology healthcare provider located in SUMTER, South Carolina. NPI 1124092697 is currently active in the NPPES registry. Verify at CMS.
Periodontology · SUMTER, SC
Registration Details
- NPI Number
- 1124092697
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Feb 14, 2006 (20.528778702287 yrs)
- Last Updated
- Jul 8, 2007
- License
-
2839/363 (SC)
Practice Information
- Address
-
3 PROFESSIONAL CTSUMTER, SC, 291501927Browse SC providers · Browse ZIP 29150
- Phone
- 8034699461
- Fax
- 8034699023
- Primary Specialty
-
Periodontology
1223P0300X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.