Stephen Leon Wallace in Clarksville - Orthodontics And Dentofacial Orthopedics
Stephen Leon Wallace - NPI 1205020286
Stephen Leon Wallace is a Orthodontics And Dentofacial Orthopedics in Clarksville, Tennessee. Stephen Leon Wallace practices all healthcare services and medical treatments related to Orthodontics And Dentofacial Orthopedics. The NPI Number for Stephen Leon Wallace is 1205020286. The last update date is 2007-08-31.
Stephen Leon Wallace's current location address is 225 Dunbar Cave Rd Ste B, Clarksville, Tennessee. You can contact this provider via phone number 9315525332 and fax number 9315526348. The mailing address for Stephen Leon Wallace is 225 Dunbar Cave Rd Ste B, Clarksville, Tennessee. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Stephen Leon Wallace |
|---|---|
| Address | 225 Dunbar Cave Rd Ste B, Clarksville, Tennessee |
| Phone Number | 9315525332 |
| Fax Number | 9315526348 |
| Sole Proprietor | Y |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1205020286 |
|---|---|
| Provider Enumeration Date | 2007-08-31 |
| Last Updated Date | 2007-08-31 |
Provider Mailing Address Detail
| Address | 225 Dunbar Cave Rd Ste B |
|---|---|
| City | Clarksville |
| State | Tennessee (TN) |
| Post Code | 370438846 |
| Phone Number | 9315525332 |
| Fax Number | 9315526348 |
Provider's Primary Taxonomy Detail
| Speciality | Orthodontics And Dentofacial Orthopedics |
|---|---|
| Taxonomy | 1223X0400X |
| Licence No | DS0000004001 |
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Definition: That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their rel |
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What is the unique 10-digit identification code issued to Stephen Leon Wallace by the Centers for Medicare & Medicaid Services?
The Stephen Leon Wallace has been assigned the NPI (National Provider Identifier) 1205020286 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Can you provide the Stephen Leon Wallace's physical address?
The Stephen Leon Wallace is physically located at 225 Dunbar Cave Rd Ste B, in the city of Clarksville, TN, with the postal code 370438846.
What is Stephen Leon Wallace's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Stephen Leon Wallace is Orthodontics And Dentofacial Orthopedics, and the taxonomy code that categorizes this field of expertise is 1223X0400X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1205020286 to Stephen Leon Wallace?
The Centers for Medicare & Medicaid Services originally issued the 1205020286 to Stephen Leon Wallace on 2007-08-31.
As of what date were the Stephen Leon Wallace's details last updated?
The information pertaining to the Stephen Leon Wallace, including its address, specialty, and other details, was most recently updated on 2007-08-31.