KEVIN D WALLACE DMD PC NPI 1841404019

NPI Information

KEVIN D WALLACE DMD, PC is a prosthodontics dentist in Springfield, MO. The provider is that branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes. KEVIN D WALLACE DMD, PC NPI is 1841404019. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1200 E WOODHURST DR
SUITE 200-A
SPRINGFIELD, MO
ZIP 65804-257
Phone: (417) 881-1123
Fax: (417) 883-0812

The provider's authorized official is Kevin D Wallace .
The authorized official title is Dentist and has the following contact phone number (417) 881-1123.

The enumeration date for this NPI number is 5/9/2007 and was last updated on 8/21/2008.

Taxonomy Codes

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Other Identifiers

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