Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. STEPHEN S WALLACE, DDS
Active Sole ProprietorDR. STEPHEN S WALLACE, DDS is a Periodontology healthcare provider located in WATERBURY, Connecticut. NPI 1679868822 is currently active in the NPPES registry. Verify at CMS.
Periodontology · WATERBURY, CT
Registration Details
- NPI Number
- 1679868822
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 16, 2011 (15.133689045095 yrs)
- Last Updated
- Mar 29, 2012
- Licenses
-
4383 (CT)044912-1 (NY)DN11169 (MA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
140 GRANDVIEW AVESUITE 102WATERBURY, CT, 067082505Browse CT providers · Browse ZIP 06708
- Phone
- 2037531112
- Fax
- 2035730773
- Primary Specialty
-
Periodontology
1223P0300X
- Additional Specialty
- Periodontology
- Additional Specialty
- Periodontology
Other Periodontology Providers in WATERBURY, CT
| Name | Credential | NPI |
|---|---|---|
| DR. WENDELL PHILIP URLING | DDS | 1700954856 |
| DR. MICHAEL ISRAEL | D.D.S. | 1710008842 |
| MR. WILLIAM ELARION TARASUK | DDS | 1932304490 |
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.