| R Jeffrey Wallace Dds Pllc | |
|
111 Peacock Court Seymour TN 37865 | |
| (865) 577-0194 | |
| (865) 577-0174 |
| Full Name | R Jeffrey Wallace Dds Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 111 Peacock Court, Seymour, Tennessee |
| Authorized Official Name and Position | R Jeffrey Wallace (OWNER PRESIDENT) |
| Authorized Official Contact | 8655770194 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| R Jeffrey Wallace Dds Pllc 111 Peacock Court Seymour TN 37865 Ph: (865) 577-0194 | R Jeffrey Wallace Dds Pllc 111 Peacock Court Seymour TN 37865 Ph: (865) 577-0194 |
| NPI Number | 1538201454 |
|---|---|
| Provider Enumeration Date | 02/14/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538201454 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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