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Individual

WALLACE C LAIL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
3415 E LAWRENCEVILLE ST, DULUTH, GA 30096-3354
(770) 476-5227
Mailing address
3415 E LAWRENCEVILLE ST, DULUTH, GA 30096-3354
(770) 476-5227

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6981
GA

Other

Enumeration date
04/30/2008
Last updated
04/30/2008
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