Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. KEVIN D WALLACE, DMD PC
Active Sole ProprietorDR. KEVIN D WALLACE, DMD PC is a Pediatric Dentistry healthcare provider located in SPRINGFIELD, Missouri. NPI 1972750909 is currently active in the NPPES registry. Verify at CMS.
Pediatric Dentistry · SPRINGFIELD, MO
Registration Details
- NPI Number
- 1972750909
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 21, 2008 (17.991490093958 yrs)
- Last Updated
- Aug 21, 2008
- License
-
014935 (MO)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1200 E WOODHURST DR STE A200SPRINGFIELD, MO, 658043745Browse MO providers · Browse ZIP 65804
- Phone
- 4178811123
- Fax
- 4178830812
- Primary Specialty
-
Pediatric Dentistry
1223P0700X
Other Pediatric Dentistry Providers in SPRINGFIELD, MO
| Name | Credential | NPI |
|---|---|---|
| DR. ROBERT LEE SWORDS | DDS | 1205944105 |
| DR. GLEN H PETTEWAY | DDS | 1235322108 |
| DR. CAROL KIM | D.D.S. | 1487958112 |
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.