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Organization
NANCY S. WALLACE, D.M.D., LTD.
Active
Organization
NANCY S. WALLACE, D.M.D., LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NANCY SMITH WALLACE D.M.D. (PRESIDENT)
(847) 662-6080
Entity
Organization
Contact information
Practice address
1709 WASHINGTON ST, WAUKEGAN, IL 60085-5133
(847) 662-6080
(847) 662-6086
Mailing address
1709 WASHINGTON ST, WAUKEGAN, IL 60085-5133
(847) 662-6080
(847) 662-6086
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
IL
Other
Enumeration date
05/20/2006
Last updated
08/22/2020
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