Individual
DR. DEBORAH S WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S
Contact information
Practice address
445 HIGHWAY 79, DOVER, TN 37058-6941
(931) 232-8287
(931) 232-2310
Mailing address
445 HIGHWAY 79, P. O. BOX 435, DOVER, TN 37058-6941
(931) 232-8287
(931) 232-2310
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS3823
TN
Other
Enumeration date
11/30/2006
Last updated
07/08/2007
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