Kevin D Wallace Dmd, Pc in Springfield - Prosthodontics
Kevin D Wallace Dmd, Pc - NPI 1841404019
Kevin D Wallace Dmd, Pc is a Prosthodontics in Springfield, Missouri. Kevin D Wallace Dmd, Pc practices all healthcare services and medical treatments related to Prosthodontics. The NPI Number for Kevin D Wallace Dmd, Pc is 1841404019. The last update date is 2008-08-21.
Kevin D Wallace Dmd, Pc's current location address is 1200 E Woodhurst Dr, Springfield, Missouri. You can contact this provider via phone number 4178811123 and fax number 4178830812. The mailing address for Kevin D Wallace Dmd, Pc is 1200 E Woodhurst Dr, Springfield, Missouri. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Kevin D Wallace Dmd, Pc |
|---|---|
| Address | 1200 E Woodhurst Dr, Springfield, Missouri |
| Phone Number | 4178811123 |
| Fax Number | 4178830812 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | DENTIST |
|---|---|
| Authorized Official Name | Wallace D Kevin |
| Credentials | D.M.D.,P.C |
| Telephone Number | 4178811123 |
NPI Number Detail
| NPI Number | 1841404019 |
|---|---|
| Provider Enumeration Date | 2007-05-09 |
| Last Updated Date | 2008-08-21 |
Provider Mailing Address Detail
| Address | 1200 E Woodhurst Dr |
|---|---|
| City | Springfield |
| State | Missouri (MO) |
| Post Code | 658044257 |
| Phone Number | 4178811123 |
| Fax Number | 4178830812 |
Provider's Primary Taxonomy Detail
| Speciality | Prosthodontics |
|---|---|
| Taxonomy | 1223P0700X |
| Licence No | 14935 |
|
Definition: That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| WA405263807 | MO | -- |
Post Comment/ Review Below
What is the unique provider identifier assigned to Kevin D Wallace Dmd, Pc?
The Kevin D Wallace Dmd, Pc has been issued the NPI (National Provider Identifier) 1841404019 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you share the physical location details of Kevin D Wallace Dmd, Pc?
The Kevin D Wallace Dmd, Pc is situated at 1200 E Woodhurst Dr, in the city of Springfield, state of MO, with the zip code 658044257.
What is the Kevin D Wallace Dmd, Pc's area of specialization and corresponding taxonomy classification?
The Kevin D Wallace Dmd, Pc's specialty field is Prosthodontics, and it falls under the taxonomy code 1223P0700X, which categorizes healthcare providers based on their specialties.
On what date did the Centers for Medicare & Medicaid Services assign the 1841404019 to Kevin D Wallace Dmd, Pc?
The Centers for Medicare & Medicaid Services assigned the 1841404019 to Kevin D Wallace Dmd, Pc on 2007-05-09.
As of what date was the information regarding Kevin D Wallace Dmd, Pc, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Kevin D Wallace Dmd, Pc, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2008-08-21.
NPI Number: 1124025044
Address: 9244 W Atlantic Blvd Apt 1238, Coral Springs, FL