Wallace, Dustin Guy
Wallace, Dustin Guy is an sole proprietor health care provider with primary practice located at 2801 S Olive St , Pine Bluff AR 71603-5433. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Wallace, Dustin Guy can be contacted via phone (870) 663-4180.Contact Information
Primary practice address
2801 S Olive St
Pine Bluff AR 71603-5433
Phone: (870) 663-4180
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 32331 | Texas |
| Dental Providers / General Practice | 1223G0001X | 4095 | Arkansas |
Profile Details
| NPI number | 1770932808 |
|---|---|
| LBN Legal business name | Wallace, Dustin Guy |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 9th, 2016 |
| Last updated | Mar 20th, 2018 - about 7 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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