Search › Idaho › 1223G0001X
Andrea Wallace, D.M.D
NPI 1871608604 · on the registry since 2006
Practice
- Address
- 2003 S Plaza Rd
Emmett, ID 83617 - Phone
- (208) 365-3534
- Fax
- (208) 365-6231
- Clinicians at this address
- 2
Registry record
- Primary taxonomy
- 1223G0001X
1223G0001X
- Licence states on file
- ID
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2007-07-09
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