Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. DEDRA DESIREE DAVIS-WALLACE, DDS
Active Sole ProprietorDR. DEDRA DESIREE DAVIS-WALLACE, DDS is a Pediatric Dentistry healthcare provider located in EAU CLAIRE, Wisconsin. NPI 1518057934 is currently active in the NPPES registry. Verify at CMS.
Pediatric Dentistry · EAU CLAIRE, WI
Registration Details
- NPI Number
- 1518057934
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Oct 14, 2006 (19.853545846337 yrs)
- Last Updated
- Jul 12, 2022
- Licenses
-
DN012272 (GA)24891 (TX)1001197-15 (WI)
- Sole Proprietor
- Yes
Practice Information
- Address
-
3131 STEIN BLVDEAU CLAIRE, WI, 547016978Browse WI providers · Browse ZIP 54701
- Phone
- 7158357172
- Fax
- 7134906464
- Primary Specialty
-
Pediatric Dentistry
1223P0221X
- Additional Specialty
- Pediatric Dentistry
- Additional Specialty
- Pediatric Dentistry
Other Pediatric Dentistry Providers in EAU CLAIRE, WI
| Name | Credential | NPI |
|---|---|---|
| DR. WALTER JOSEPH TURNER | D.D.S. | 1710087473 |
| DR. NEAL R BENHAM | DDS | 1780701821 |
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.