Individual
DR. LAWRENCE NORMAN WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2 MIDDLE CANYON RD, CARMEL VALLEY, CA 93924-9404
(831) 659-9300
Mailing address
2 MIDDLE CANYON RD, CARMEL VALLEY, CA 93924-9404
(831) 659-9300
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
21-770
IL
Other
Enumeration date
04/30/2008
Last updated
04/30/2008
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