Individual
DR. FAITH WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
674 BLVD DE FRANCE, PORT ROYAL, SC 29902
(214) 794-5525
Mailing address
674 BLVD DE FRANCE, PORT ROYAL, SC 29902
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
40437
TX
Other
Enumeration date
08/02/2024
Last updated
08/02/2024
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