PHILLIP W WALLACE DDS INC NPI 1699140202

NPI Information

PHILLIP W WALLACE DDS INC is a general practice dentist in Willoughby, OH. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. PHILLIP W WALLACE DDS INC NPI is 1699140202. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

36001 EUCLID AVE
SUITE A-15
WILLOUGHBY, OH
ZIP 44094-643
Phone: (440) 946-5485
Fax: (440) 946-5810

The provider's authorized official is Phillip W Wallace .
The authorized official title is Owner and has the following contact phone number (440) 946-5484.

The enumeration date for this NPI number is 12/8/2015 and was last updated on 12/8/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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