Individual
DR. ROBERT EDWARD WALLACE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
425 APPERSON DR, SALEM, VA 24153-7026
(540) 387-5817
Mailing address
425 APPERSON DR, SALEM, VA 24153-7026
(540) 387-5817
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401003442
VA
Other
Enumeration date
08/09/2005
Last updated
07/08/2007
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