Stephen Wallace Dds Pc in Waterbury - Periodontics
Stephen Wallace Dds Pc - NPI 1629121561
Stephen Wallace Dds Pc is a Periodontics in Waterbury, Connecticut. Stephen Wallace Dds Pc practices all healthcare services and medical treatments related to Periodontics. The NPI Number for Stephen Wallace Dds Pc is 1629121561. The last update date is 2012-03-22.
Stephen Wallace Dds Pc's current location address is 140 Grandview Ave, Waterbury, Connecticut. You can contact this provider via phone number 2037531112 and fax number 2035730773. The mailing address for Stephen Wallace Dds Pc is 140 Grandview Ave, Waterbury, Connecticut. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Stephen Wallace Dds Pc |
|---|---|
| Address | 140 Grandview Ave, Waterbury, Connecticut |
| Phone Number | 2037531112 |
| Fax Number | 2035730773 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OFFICE MAN |
|---|---|
| Authorized Official Name | Cathcart M Jennifer |
| Telephone Number | 2037531112 |
NPI Number Detail
| NPI Number | 1629121561 |
|---|---|
| Provider Enumeration Date | 2007-01-22 |
| Last Updated Date | 2012-03-22 |
Provider Mailing Address Detail
| Address | 140 Grandview Ave |
|---|---|
| City | Waterbury |
| State | Connecticut (CT) |
| Post Code | 6708 |
| Phone Number | 2037531112 |
| Fax Number | 2035730773 |
Provider's Primary Taxonomy Detail
| Speciality | Periodontics |
|---|---|
| Taxonomy | 1223P0300X |
| Licence No | 044912-1 |
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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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Post Comment/ Review Below
What is the unique identifier code issued to Stephen Wallace Dds Pc by the Centers for Medicare & Medicaid Services (CMS)?
The Stephen Wallace Dds Pc has been assigned the NPI (National Provider Identifier) 1629121561. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you please provide the complete physical location address of Stephen Wallace Dds Pc?
The Stephen Wallace Dds Pc is physically situated at 140 Grandview Ave, in the city of Waterbury, state of CT, with the postal code 6708.
What is Stephen Wallace Dds Pc's specialized field of practice, and what is the corresponding taxonomy classification code?
The Stephen Wallace Dds Pc's area of specialization is Periodontics, and the corresponding taxonomy code that categorizes this field of practice is 1223P0300X.
When did Stephen Wallace Dds Pc receive its 1629121561 assignment?
The Stephen Wallace Dds Pc was assigned its 1629121561 on 2007-01-22, which is the date when this unique identifier was issued to the organization.
When was the information regarding Stephen Wallace Dds Pc most recently updated?
The details pertaining to the Stephen Wallace Dds Pc, including its address, specialty, and other relevant information, were last refreshed on 2012-03-22.
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