Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. MICHAEL J WALLACE, DDS
Active Sole ProprietorDR. MICHAEL J WALLACE, DDS is a Dentist healthcare provider located in EDMOND, Oklahoma. NPI 1417014424 is currently active in the NPPES registry. Verify at CMS.
Dentist · EDMOND, OK
Registration Details
- NPI Number
- 1417014424
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jan 2, 2007 (19.439280414285 yrs)
- Last Updated
- Jan 28, 2021
- License
-
5801 (OK)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1617 E DANFORTH RDEDMOND, OK, 730343103Browse OK providers · Browse ZIP 73034
- Phone
- 4053400411
- Fax
- 4053403217
- Primary Specialty
-
Dentist
122300000X
Other Dentist Providers in EDMOND, OK
| Name | Credential | NPI |
|---|---|---|
| DR. MICHAEL HANSEN | D.D.S. | 1255349312 |
| DR. TOM KIRBY BALL | DDS | 1033298146 |
| MR. FRED G WINTERS | DDS | 1811054414 |
| MICHAEL F ALSPAUGH | D.D.S. | 1063567022 |
| DR. DONALD G. ASHBURN JR. | D.D.S. | 1962540336 |
| DR. GENE M. KOOP | D.D.S. | 1265659304 |
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.