Wallace, John David
Wallace, John David is an individual health care provider with primary practice located at 8315 Walnut Hill Ln Ste 120 , Dallas TX 75231-4218. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Wallace, John David can be contacted via phone (214) 363-9946.Contact Information
Primary practice address
8315 Walnut Hill Ln Ste 120
Dallas TX 75231-4218
Phone: (214) 363-9946
Fax: (214) 389-1953
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 19862 | Texas |
Profile Details
| NPI number | 1811978349 |
|---|---|
| LBN Legal business name | Wallace, John David |
| Credentials | DDS, MD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 10th, 2005 |
| Last updated | Jun 16th, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1811978349 | NPPES |
| Texas | MEDICAID | 1750242-02 |
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