Individual
DR. JIMMY LEE WARDLAW SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
107 SCENIC DR, ROCKWALL, TX 75032-8615
(972) 771-8602
(972) 771-8602
Mailing address
107 SCENIC DR, ROCKWALL, TX 75032-8615
(972) 771-8602
(972) 771-8602
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8100
TX
Other
Enumeration date
01/04/2012
Last updated
01/04/2012
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