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Individual

DR. JOSEPH FRANCIS WALLACE III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
23 MAPLE AVE, GREENWICH, CT 06830-5620
(203) 661-5858
(203) 661-1159
Mailing address
23 MAPLE AVE, GREENWICH, CT 06830-5620
(203) 661-5858
(203) 661-1159

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
040760
NY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
7023
CT

Other

Enumeration date
10/13/2006
Last updated
07/08/2007
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