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Dustin Wallace, DDS
NPI 1770932808 · on the registry since 2016 · sole proprietor
Practice
- Address
- 2801 S Olive St
Pine Bluff, AR 71603 - Phone
- (870) 663-4180
- Organisation at this address
- Brad Bryan,Dmd, Pa
Burris-Dake Oral Surgery
Southeast Arkansas Physical Therapy, Inc.
Archwell Health Professional Services Of Arkansas PaInferred from a shared address, not stated in the registry. - Clinicians at this address
- 12
Registry record
- Primary taxonomy
- General Practice Dentistry
1223G0001X
- Also registered as
- General Practice Dentistry
- Licence states on file
- TX, AR
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2018-03-20
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 Arkansas