Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. KEVIN BRUCE WALLACE, D.M.D.
Active Sole ProprietorDR. KEVIN BRUCE WALLACE, D.M.D. is a Dentist healthcare provider located in LEESBURG, Florida. NPI 1316960131 is currently active in the NPPES registry. Verify at CMS.
Dentist · LEESBURG, FL
Registration Details
- NPI Number
- 1316960131
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 25, 2006 (20.094944609571 yrs)
- Last Updated
- Nov 2, 2011
- License
-
DN15774 (FL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
949 N 14TH STLEESBURG, FL, 347483838Browse FL providers · Browse ZIP 34748
- Phone
- 3528160855
- Primary Specialty
-
Dentist
122300000X
Other Dentist Providers in LEESBURG, FL
| Name | Credential | NPI |
|---|---|---|
| ELDON LEON BUNN | DDS | 1164535621 |
| LEE D TATRO | DDS | 1205966868 |
| HERB L BENNETT | DMD | 1114145281 |
| DR. ALI A. VAZIRI | D.M.D. | 1700041324 |
| DR. PATRICIA CONSUELO GONZALEZ | DMD | 1760633739 |
| DR. JON D MEHR | DDS | 1720379811 |
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.