Organization
RICHARD J. WALLACE, DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD J WALLACE DDS (OWNER)
(303) 690-7778
Entity
Organization
Contact information
Practice address
20921 E SMOKY HILL RD UNIT A, CENTENNIAL, CO 80015-5126
(303) 690-7778
(303) 690-1158
Mailing address
20921 E SMOKY HILL RD UNIT A, CENTENNIAL, CO 80015-5126
(303) 690-7778
(303) 690-1158
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
12/15/2014
Last updated
12/15/2014
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