Individual
DR. GERALD F WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
8181 E TUFTS AVE, SUITE 550, DENVER, CO 80237-2579
(720) 488-9090
(720) 488-9091
Mailing address
4101 E ELLSWORTH AVE, DENVER, CO 80246-1058
(303) 399-1832
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
105010
CO
Other
Enumeration date
04/26/2007
Last updated
07/08/2007
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