Individual
DR. MARY TAYLOR WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
112 W GRAND AVE, RAINBOW CITY, AL 35906-3233
(256) 442-7751
(256) 413-7718
Mailing address
112 W GRAND AVE, RAINBOW CITY, AL 35906-3233
(256) 442-7751
(256) 413-7718
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3642
AL
Other
Enumeration date
01/18/2007
Last updated
07/08/2007
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