Search › North Carolina › 1223G0001X
Jody Wallace, D.D.S
NPI 1740210103 · on the registry since 2006
Practice
- Address
- 2148 Highway 54
Graham, NC 27253 - Phone
- (336) 578-3884
- Fax
- (336) 578-3814
- Organisation at this address
- Jerry Crayle
Inferred from a shared address, not stated in the registry.
Registry record
- Primary taxonomy
- 1223G0001X
1223G0001X
- Licence states on file
- NC
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2007-07-08
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in North Carolina