Wallace, R Jeffrey
Wallace, R Jeffrey is an individual health care provider with primary practice located at 11135 Chapman Hwy , Seymour TN 37865-4857. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Wallace, R Jeffrey can be contacted via phone (865) 577-1963.Contact Information
Primary practice address
11135 Chapman Hwy
Seymour TN 37865-4857
Phone: (865) 577-1963
Fax: (865) 577-1014
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | D54694 | Tennessee |
Profile Details
| NPI number | 1285744151 |
|---|---|
| LBN Legal business name | Wallace, R Jeffrey |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 30th, 2006 |
| Last updated | Oct 10th, 2016 - about 10 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 | 1285744151 | NPPES |
| Tennessee | Other | 0063801 | BCBS |
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