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Individual
DR. WILLIAM DEAN WALLACE
Active
Individual
DR. WILLIAM DEAN WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207ZI0100X
Immunopathology Physician
Primary
168418-1205
UT
Other
Enumeration date
10/16/2013
Last updated
10/16/2013
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