Stephen Anthony Wallace, D.D.S.

Dentist · La Grange, IL

Individual Active NPI

NPI number 1780781831

Practice location

310 W Burlington Ave
La Grange, IL 60525-2363
Phone
(708) 352-2223

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NPI record

NPI
1780781831
Entity type
Individual (Type 1)
Enumeration date
September 20, 2006
Last updated
July 8, 2007
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Dentist Primary 122300000X — IL

About Dr. Wallace

Stephen Anthony Wallace, D.D.S. is a healthcare provider registered in the NPI registry with the primary taxonomy Dentist (code 122300000X). The practice location is 310 W Burlington Ave, La Grange, IL 60525-2363. The NPI number 1780781831 was assigned on September 20, 2006 and the record was last updated on July 8, 2007.

Frequently asked questions

What is the NPI number of Stephen Anthony Wallace, D.D.S.?

The NPI number is 1780781831.

What is the phone number of Dr. Wallace?

The phone number listed for the practice location is (708) 352-2223.

Where is Dr. Wallace located?

310 W Burlington Ave, La Grange, IL 60525-2363.

What is the taxonomy code for Dr. Wallace?

The primary taxonomy code is 122300000X – Dentist.

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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