Michael J Wallace is a Dentist in Edmond, Oklahoma. Michael J Wallace practices all healthcare services and medical treatments related to Dentist. The NPI Number for Michael J Wallace is 1417014424. The last update date is 2021-01-28.
Michael J Wallace's current location address is 1617 E Danforth Road, Edmond, Oklahoma. You can contact this provider via phone number 4053400411 and fax number 4053403217. The mailing address for Michael J Wallace is 1617 E Danforth Road, Edmond, Oklahoma. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Michael J Wallace |
|---|---|
| Address | 1617 E Danforth Road, Edmond, Oklahoma |
| Phone Number | 4053400411 |
| Fax Number | 4053403217 |
| Sole Proprietor | Y |
| Credentials | DDS |
NPI Number Detail
| NPI Number | 1417014424 |
|---|---|
| Provider Enumeration Date | 2007-01-02 |
| Last Updated Date | 2021-01-28 |
Provider Mailing Address Detail
| Address | 1617 E Danforth Road |
|---|---|
| City | Edmond |
| State | Oklahoma (OK) |
| Post Code | 730346622 |
| Phone Number | 4053400411 |
| Fax Number | 4053403217 |
Provider's Primary Taxonomy Detail
| Speciality | Dentist |
|---|---|
| Taxonomy | 122300000X |
| Licence No | 5801 |
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Definition: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: denti |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 200066490 A | OK | -- |
Post Comment/ Review Below
What is the unique provider identifier assigned to Michael J Wallace?
The Michael J Wallace has been issued the NPI (National Provider Identifier) 1417014424 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you provide the complete physical address where Michael J Wallace is located?
The Michael J Wallace is situated at the following address: 1617 E Danforth Road, Edmond, OK, 730346622.
What is Michael J Wallace's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Michael J Wallace is Dentist, and the taxonomy code that classifies this field of practice is 122300000X.
When did the Michael J Wallace receive its 1417014424?
The Michael J Wallace was issued its 1417014424 on 2007-01-02, which is the date when the organization was assigned this unique identifier.
When was the information regarding Michael J Wallace most recently updated?
The details pertaining to the Michael J Wallace, including its address, specialty, and other relevant information, were last refreshed on 2021-01-28.