Individual
DR. LAUREN WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D
Contact information
Practice address
1306 14TH AVE SE, DECATUR, AL 35601-4346
(256) 350-5810
Mailing address
613 HALEY ANN DR SW, HARTSELLE, AL 35640-3812
(256) 466-3131
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6194
AL
Other
Enumeration date
06/16/2015
Last updated
06/16/2015
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