Kevin Wallace, DMD PC

NPI 1972750909 · on the registry since 2008 · sole proprietor

Practice

Address: 1200 E Woodhurst Dr Ste A200
Springfield, MO 65804
Phone: (417) 881-1123
Fax: (417) 883-0812
Organisation at this address: Nail Dental Llc
Wayne B Miles Md Pc
Ryan B Perkins Dc Llc
Discover Audiology, Llc
Kevin D Wallace Dmd, Pc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 38

Registry record

Primary taxonomy: Prosthodontics
1223P0700X
Licence states on file: MO
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2008-08-21

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 Missouri