Individual provider · Type 1 NPI

Oscar Russell Wallace

General Practice Dentistry · Cumming, GA

NPI number 1215722509 Active

Practice location

312 Tribble Gap Rd
Cumming, GA 30040-2440

Call (770) 887-1399 Map

Mailing address

2545 Pine Bluff Dr
Decatur, GA 30033-4927

Specialties and licenses

TaxonomyCodeLicense
General Practice Dentistry Primary 1223G0001XDN123883 (GA)

General Practice Dentistry: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

6 other providers at this address

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About NPI 1215722509

Oscar Russell Wallace's National Provider Identifier is 1215722509, issued on Apr 9, 2025. The primary taxonomy on file is General Practice Dentistry (1223G0001X), and the practice location is in Cumming, GA. The record was last updated on Sep 17, 2025.