Kevin D Wallace DMD, PC

Prosthodontics · Springfield, MO

Organization Active NPI

NPI number 1841404019

Practice location

1200 E Woodhurst Dr
Suite 200-A
Springfield, MO 65804-4257
Phone
(417) 881-1123
Fax
(417) 883-0812

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NPI record

NPI
1841404019
Entity type
Organization (Type 2)
Enumeration date
May 9, 2007
Last updated
August 21, 2008
Organization subpart
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Prosthodontics Primary 1223P0700X 014935 MO

Authorized official

Name
Dr. Kevin D Wallace, D.M.D.,P.C.
Title
Dentist
Phone
(417) 881-1123

About Kevin D Wallace DMD, PC

Kevin D Wallace DMD, PC is a healthcare organization registered in the NPI registry with the primary taxonomy Prosthodontics (code 1223P0700X). The practice location is 1200 E Woodhurst Dr, Suite 200-A, Springfield, MO 65804-4257. The NPI number 1841404019 was assigned on May 9, 2007 and the record was last updated on August 21, 2008.

Kevin D Wallace DMD, PC lists a license in the registry: #014935 (MO) for Prosthodontics. License numbers are self-reported to NPPES; verify them with the state licensing board.

The authorized official for this organization is Dr. Kevin D Wallace, D.M.D.,P.C., Dentist.

Frequently asked questions

What is the NPI number of Kevin D Wallace DMD, PC?

The NPI number is 1841404019.

What is the phone number of Kevin D Wallace DMD, PC?

The phone number listed for the practice location is (417) 881-1123.

Where is Kevin D Wallace DMD, PC located?

1200 E Woodhurst Dr, Suite 200-A, Springfield, MO 65804-4257.

What is the taxonomy code for Kevin D Wallace DMD, PC?

The primary taxonomy code is 1223P0700X – Prosthodontics.

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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