Individual
DR. ERIC H WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
28 SE 6TH ST, BOCA RATON, FL 33432-6016
(561) 391-0020
(561) 391-8863
Mailing address
1140 SW 21ST LN, BOCA RATON, FL 33486-6722
(561) 393-6385
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN0008299
FL
Other
Enumeration date
02/13/2007
Last updated
07/08/2007
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