# D & A WALLACE, INC.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144498437
- **Authorized official:** MRS. ANDREA LAYNE WALLACE D.M.D. (SECRETARY/OWNER)
- **Authorized official phone:** (208) 365-3534

## Contact information

- **Practice address:** 2003 E QUAIL RUN RD, EMMETT, ID 83617-5059
- **Practice address phone:** (208) 365-3534
- **Practice address fax:** (208) 365-6231
- **Mailing address:** 2003 E QUAIL RUN RD, EMMETT, ID 83617-5059
- **Mailing address phone:** (208) 365-3534
- **Mailing address fax:** (208) 365-6231

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 3656 | ID | Yes |

## Other

- **Enumeration date:** 02/20/2008
- **Last updated:** 02/20/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 8071026 | — | ID |