Individual provider · Type 1 NPI
John David Wallace, DDS, MD
Oral and Maxillofacial Surgery (Dentist) · Dallas, TX
NPI number
1811978349
Active
Practice location
8315 Walnut Hill Ln Ste 120
Dallas, TX 75231-4218
Fax (214) 389-1953
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) Primary | 1223S0112X | 19862 (TX) |
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.
2 other providers at this address
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About NPI 1811978349
John David Wallace, DDS, MD's National Provider Identifier is 1811978349, issued on Nov 10, 2005. The primary taxonomy on file is Oral and Maxillofacial Surgery (Dentist) (1223S0112X), and the practice location is in Dallas, TX. The record was last updated on Jun 16, 2023.