Marshall Lynn Wallace in Sumter - Periodontics
Marshall Lynn Wallace - NPI 1124092697
Marshall Lynn Wallace is a Periodontics in Sumter, South Carolina. Marshall Lynn Wallace practices all healthcare services and medical treatments related to Periodontics. The NPI Number for Marshall Lynn Wallace is 1124092697. The last update date is 2007-07-08.
Marshall Lynn Wallace's current location address is 3 Professional Ct, Sumter, South Carolina. You can contact this provider via phone number 8034699461 and fax number 8034699023. The mailing address for Marshall Lynn Wallace is 3 Professional Ct, Sumter, South Carolina. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Marshall Lynn Wallace |
|---|---|
| Address | 3 Professional Ct, Sumter, South Carolina |
| Phone Number | 8034699461 |
| Fax Number | 8034699023 |
| Sole Proprietor | X |
| Credentials | DMD |
NPI Number Detail
| NPI Number | 1124092697 |
|---|---|
| Provider Enumeration Date | 2006-02-14 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 3 Professional Ct |
|---|---|
| City | Sumter |
| State | South Carolina (SC) |
| Post Code | 291501927 |
| Phone Number | 8034699461 |
| Fax Number | 8034699023 |
Provider's Primary Taxonomy Detail
| Speciality | Periodontics |
|---|---|
| Taxonomy | 1223P0300X |
| Licence No | 2839/363 |
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Definition: That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structure |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| ZA9760 | SC | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Marshall Lynn Wallace by the Centers for Medicare & Medicaid Services?
The Marshall Lynn Wallace has been issued the NPI (National Provider Identifier) 1124092697, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of Marshall Lynn Wallace?
The Marshall Lynn Wallace is situated at 3 Professional Ct, in the city of Sumter, state of SC, with the zip code 291501927.
What is the area of specialization for Marshall Lynn Wallace, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Marshall Lynn Wallace is Periodontics, and the corresponding taxonomy code that categorizes this area of expertise is 1223P0300X.
On what date did Marshall Lynn Wallace receive its 1124092697 assignment from the Centers for Medicare & Medicaid Services?
The Marshall Lynn Wallace was assigned its 1124092697 on 2006-02-14, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
When was the information regarding Marshall Lynn Wallace, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Marshall Lynn Wallace, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2007-07-08.
NPI Number: 1215930425
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