Individual
DR. CAMERON S WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
6127 N FRY RD, KATY, TX 77449-5563
(281) 550-3795
Mailing address
6127 N FRY RD, KATY, TX 77449-5563
(281) 550-3795
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
23910
TX
Other
Enumeration date
06/02/2009
Last updated
06/02/2009
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