SearchIdaho1223G0001X

Darren Wallace, D.M.D

NPI 1841305646 · on the registry since 2006

Practice

Address
2003 E Quail Run Rd
Emmett, ID 83617
Phone
(208) 365-3534
Fax
(208) 365-6231
Organisation at this address
D & A Wallace, Inc.
Idaho Dental Professionals, P.C.
Inferred from a shared address, not stated in the registry.

Registry record

Primary taxonomy
1223G0001X
1223G0001X
Licence states on file
ID
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2014-01-16

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 Idaho