Individual
DR. CAROLE A WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
82 BRIDGE AVE, RED BANK, NJ 07701-1160
(732) 530-2662
Mailing address
64 WINDSOR DR, EATONTOWN, NJ 07724-2165
(732) 389-2454
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019148
NJ
Other
Enumeration date
05/22/2007
Last updated
07/08/2007
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