Wallace, John Kline

Wallace, John Kline is an individual health care provider with primary practice located at 2501 Princess Anne St , Fredericksburg VA 22401-3333. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Wallace, John Kline can be contacted via phone (540) 371-0004.

Contact Information

Primary practice address
2501 Princess Anne St Fredericksburg VA 22401-3333
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 0401005254 Virginia

Profile Details

NPI number 1316038839
LBN Legal business name Wallace, John Kline
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 28th, 2006
Last updated Jul 8th, 2007 - about 17 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 1316038839 NPPES
Virginia MEDICAID 7821565
Virginia Other 080223
Virginia Other 9130
Virginia Other 0821731

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