Individual
DR. MARK ARTHUR WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1901 RESEARCH BLVD, SUITE 200, ROCKVILLE, MD 20850-3164
(301) 309-0707
(301) 309-8169
Mailing address
1901 RESEARCH BLVD, SUITE 200, ROCKVILLE, MD 20850-3164
(301) 309-0707
(301) 309-8169
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5043
MD
Other
Enumeration date
10/10/2006
Last updated
07/08/2007
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