David A. Wallace, Dds, Ms, Ltd.

LBN: David A. Wallace, Dds, Ms, Ltd.
David A. Wallace, Dds, Ms, Ltd. is an health care organization with primary practice located at 3712 S Main St , Blacksburg VA 24060-7017. The organization recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as the primary health care specialty. David A. Wallace, Dds, Ms, Ltd. can be contacted via phone (540) 552-7222, or through Hurst, Ella via phone (304) 425-2611.

Contact Information

Primary practice address
3712 S Main St Blacksburg VA 24060-7017
Phone: (540) 552-7222
Fax: (540) 953-3096
Website:
Map and Directions
Authorized official contact:
Name: Hurst, Ella
Phone: (304) 425-2611

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 03440 Virginia
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 1880 West Virginia

Profile Details

NPI number 1356536593
LBN Legal business name David A. Wallace, Dds, Ms, Ltd.
DBA Doing business as
Authorized official Hurst, Ella
Entity Organization
Organization subpart 1 No
Enumeration date Sep 11th, 2007
Last updated Sep 6th, 2023 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356536593 NPPES
West Virginia MEDICAID 0138333000
West Virginia MEDICAID 8000476

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