Individual
CHRISTOPHER J WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1400 TOWNVIEW LN, SANTA ROSA, CA 95405-7538
(707) 578-8100
(707) 578-5109
Mailing address
1400 TOWNVIEW LN, SANTA ROSA, CA 95405-7538
(707) 578-8100
(707) 578-5109
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30663
CA
Other
Enumeration date
02/26/2007
Last updated
07/08/2007
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