Individual
JAMES C WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1680 HUGUENOT RD, MIDLOTHIAN, VA 23113-2427
(804) 379-7120
(804) 379-9835
Mailing address
1680 HUGUENOT RD, MIDLOTHIAN, VA 23113-2427
(804) 379-7120
(804) 379-9835
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
04729
VA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
06504
FL
Other
Enumeration date
09/20/2006
Last updated
07/08/2007
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