Individual
ASHLEY WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
17122 BULVERDE RD STE 102, SAN ANTONIO, TX 78247-3211
(210) 495-2000
Mailing address
21626 STONEWALL PKWY APT 3312, SAN ANTONIO, TX 78256-1716
(413) 348-4847
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
39215
TX
Other
Enumeration date
02/21/2023
Last updated
02/21/2023
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