Individual
DENNIS LEE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
4100 BEECHER RD, SUITE A, FLINT, MI 48532-3661
(810) 342-3800
(810) 342-3784
Mailing address
4100 BEECHER RD, SUITE A, FLINT, MI 48532-3661
(810) 342-3800
(810) 342-3784
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601002261
MI
Other
Enumeration date
05/23/2006
Last updated
08/11/2010
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