Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
GINA WALLACE
Active Sole ProprietorGINA WALLACE is a Dental Hygienist healthcare provider located in BRUNSWICK, Georgia. NPI 1417699505 is currently active in the NPPES registry. Verify at CMS.
Dental Hygienist · BRUNSWICK, GA
Registration Details
- NPI Number
- 1417699505
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Apr 10, 2022 (4.3929381566309 yrs)
- Last Updated
- Apr 10, 2022
- License
-
DH043989 (GA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
4741 ALTAMA AVEBRUNSWICK, GA, 315202910Browse GA providers · Browse ZIP 31520
- Phone
- 9122621081
- Primary Specialty
-
Dental Hygienist
124Q00000X
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.