Individual
WALLACE SIGMON MCLAURIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
222 PIEDMONT AVE, CINCINNATI, OH 45219
(513) 475-8783
(513) 475-7698
Mailing address
2830 VICTORY PKWY, CINCINNATI, OH 45206-1785
(513) 475-8783
(513) 475-7698
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
30.025891
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/24/2015
Last updated
07/16/2019
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