Individual provider · Type 1 NPI
Lawrence Norman Wallace
Oral and Maxillofacial Surgery (Dentist) · Carmel Valley, CA
NPI number
1043486962
Active
Practice location
2 Middle Canyon Rd
Carmel Valley, CA 93924-9404
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) Primary | 1223S0112X | 21-770 (IL) |
Oral and Maxillofacial Surgery (Dentist): The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
About NPI 1043486962
Lawrence Norman Wallace's National Provider Identifier is 1043486962, issued on Apr 30, 2008. The primary taxonomy on file is Oral and Maxillofacial Surgery (Dentist) (1223S0112X), and the practice location is in Carmel Valley, CA. The record was last updated on Apr 30, 2008.