| Robert R Wallace Dmd Pa | |
|
40 Creekview Ct Greenville SC 29615-4800 | |
| (864) 676-0825 | |
| (864) 676-9859 |
| Full Name | Robert R Wallace Dmd Pa |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 40 Creekview Ct, Greenville, South Carolina |
| Authorized Official Name and Position | Robert Raymond Wallace (PRESIDENT) |
| Authorized Official Contact | 8646760825 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Robert R Wallace Dmd Pa 40 Creekview Ct Greenville SC 29615-4800 Ph: (864) 676-0825 | Robert R Wallace Dmd Pa 40 Creekview Ct Greenville SC 29615-4800 Ph: (864) 676-0825 |
| NPI Number | 1881614253 |
|---|---|
| Provider Enumeration Date | 07/20/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881614253 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 1774 (South Carolina) | Primary |
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