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Individual

DR. ROY T. WALLACE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
655 BOSTON RD STE 3A, BILLERICA, MA 01821-5338
(978) 667-0691
Mailing address
655 BOSTON RD STE 3A, BILLERICA, MA 01821-5338
(978) 667-0691

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
13403
MA

Other

Enumeration date
02/12/2007
Last updated
07/08/2007
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