Individual provider · Type 1 NPI
Leslie Suzanne Wallace, DMD
Pediatric Dentistry · Lebanon, TN
NPI number
1629301833
Active
Practice location
103 Physicians Way, Suite 150
Lebanon, TN 37090-4104
Mailing address
179 Cobbler Cir
Hendersonville, TN 37075-3963
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Dentistry Primary | 1223P0221X | 8973 (TN) |
Pediatric Dentistry: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
Another provider at this address
Other pediatric dentistry providers in Lebanon
About NPI 1629301833
Leslie Suzanne Wallace, DMD's National Provider Identifier is 1629301833, issued on Sep 8, 2009. The primary taxonomy on file is Pediatric Dentistry (1223P0221X), and the practice location is in Lebanon, TN. The record was last updated on Jan 8, 2014.