Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. DOUGLAS W. WALLACE, D.D.S., M.S.
ActiveDR. DOUGLAS W. WALLACE, D.D.S., M.S. is a Oral & Maxillofacial Surgery (Physician) healthcare provider located in FAIRFIELD, Ohio. NPI 1376698753 is currently active in the NPPES registry. Verify at CMS.
Oral & Maxillofacial Surgery (Physician) · FAIRFIELD, OH
Registration Details
- NPI Number
- 1376698753
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jan 24, 2007 (19.58616741881 yrs)
- Last Updated
- Apr 1, 2008
- License
-
30-01-6806 (OH)
Practice Information
- Address
-
5188 WINTON RDFAIRFIELD, OH, 450142900Browse OH providers · Browse ZIP 45014
- Phone
- 5138298080
- Fax
- 5138584290
- Primary Specialty
-
Oral & Maxillofacial Surgery (Physician)
204E00000X
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.