DR. Dedra Desiree Wallace, DDS is a pediatric dentistry dentist in Houston, TX. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. DR. Dedra Desiree Wallace, DDS NPI is 1518057934. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a female.
The provider's business location address is:
12711 FM 1960 RD W
HOUSTON, TX
ZIP 77065-014
Phone: (713) 490-8880
Fax: (713) 490-6464
The NPI 1518057934 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).
The enumeration date for this NPI number is 10/14/2006 and was last updated on 4/18/2012.