Individual
DR. STEPHEN S WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
140 GRANDVIEW AVE, SUITE 102, WATERBURY, CT 06708-2505
(203) 753-1112
(203) 573-0773
Mailing address
140 GRANDVIEW AVE, SUITE 102, WATERBURY, CT 06708-2505
(203) 753-1112
(203) 573-0773
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
044912-1
NY
1223P0300X
Periodontics
Primary
4383
CT
1223P0300X
Periodontics
DN11169
MA
Other
Enumeration date
06/16/2011
Last updated
03/29/2012
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us