Wallace, Charles Wayne

Wallace, Charles Wayne is an individual health care provider with primary practice located at 502 N Coalter St , Staunton VA 24401-3401. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Wallace, Charles Wayne can be contacted via phone (540) 885-3060.

Contact Information

Primary practice address
502 N Coalter St Staunton VA 24401-3401
Phone: (540) 885-3060
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 0401003798 Virginia

Profile Details

NPI number 1073643862
LBN Legal business name Wallace, Charles Wayne
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 7th, 2007
Last updated Mar 7th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073643862 NPPES
Virginia Other B23831643 DRIVER'S LICENSE
Virginia Other 0401003798 DRIVER'S LICENSE

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