MICHAEL J. WALLACE D.D.S. NPI 1669519559

NPI Information

MICHAEL J. WALLACE D.D.S. is a general practice dentist in Edmond, OK. 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. MICHAEL J. WALLACE D.D.S. NPI is 1669519559. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1600 E 19TH ST
SUITE 301
EDMOND, OK
ZIP 73013-622
Phone: (405) 340-0411
Fax: (405) 340-3217

The provider's authorized official is Michael J Wallace .
The authorized official title is Dentist and has the following contact phone number (405) 340-0411.

The enumeration date for this NPI number is 1/31/2007 and was last updated on 8/22/2020.

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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