Individual provider · Type 1 NPI

Bradley Wallace, DMD

General Practice Dentistry · Sandy, UT

NPI number 1487546305 Active

Practice location

853 E 9400 S
Sandy, UT 84094-3655

Mailing address

5327 W Canary Grass Way
South Jordan, UT 84009-1399

Other practice locations

  • 6065 S Fashion Blvd Ste 275, Murray, UT 84107-5441 · (462) 880-1262

Specialties and licenses

TaxonomyCodeLicense
General Practice Dentistry Primary 1223G0001X14228509-9926 (UT)

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.

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About NPI 1487546305

Bradley Wallace, DMD's National Provider Identifier is 1487546305, issued on Jul 16, 2025. The primary taxonomy on file is General Practice Dentistry (1223G0001X), and the practice location is in Sandy, UT. The record was last updated on Jul 16, 2025.