Kevin D. Wallace, DMD PC

Prosthodontics · Springfield, MO

Individual Active NPI

NPI number 1972750909

Practice location

1200 E Woodhurst Dr Ste a200
Springfield, MO 65804-3745
Phone
(417) 881-1123
Fax
(417) 883-0812

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NPI record

NPI
1972750909
Entity type
Individual (Type 1)
Enumeration date
August 21, 2008
Last updated
August 21, 2008
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Prosthodontics Primary 1223P0700X 014935 MO

About Kevin Wallace

Kevin D. Wallace, DMD PC is a healthcare provider registered in the NPI registry with the primary taxonomy Prosthodontics (code 1223P0700X). The practice location is 1200 E Woodhurst Dr Ste a200, Springfield, MO 65804-3745. The NPI number 1972750909 was assigned on August 21, 2008 and the record was last updated on August 21, 2008.

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

Frequently asked questions

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

The NPI number is 1972750909.

What is the phone number of Kevin Wallace?

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

Where is Kevin Wallace located?

1200 E Woodhurst Dr Ste a200, Springfield, MO 65804-3745.

What is the taxonomy code for Kevin Wallace?

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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