Brian Wallace, DMD

General Practice Dentistry · Prestonsburg, KY

Individual Active NPI

NPI number 1093866121

Practice location

781 S Lake Dr
Suite 1
Prestonsburg, KY 41653-1340
Phone
(606) 886-2676
Fax
(606) 886-2741

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NPI record

NPI
1093866121
Entity type
Individual (Type 1)
Enumeration date
January 16, 2007
Last updated
July 8, 2007
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
General Practice Dentistry Primary 1223G0001X 7008 KY

Mailing address

3900 Ky Route 1750
East Point, KY 41216-8824

About Dr. Wallace

Brian Wallace, DMD is a healthcare provider registered in the NPI registry with the primary taxonomy General Practice Dentistry (code 1223G0001X). The practice location is 781 S Lake Dr, Suite 1, Prestonsburg, KY 41653-1340. The NPI number 1093866121 was assigned on January 16, 2007 and the record was last updated on July 8, 2007.

Dr. Wallace lists a license in the registry: #7008 (KY) for General Practice Dentistry. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Brian Wallace, DMD?

The NPI number is 1093866121.

What is the phone number of Dr. Wallace?

The phone number listed for the practice location is (606) 886-2676.

Where is Dr. Wallace located?

781 S Lake Dr, Suite 1, Prestonsburg, KY 41653-1340.

What is the taxonomy code for Dr. Wallace?

The primary taxonomy code is 1223G0001X – General Practice Dentistry.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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