Wallace, Matt
Wallace, Matt is an individual health care provider with primary practice located at 9290 Telephone Rd , Ventura CA 93004-2601. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Wallace, Matt can be contacted via phone (805) 671-9697.Contact Information
Primary practice address
9290 Telephone Rd
Ventura CA 93004-2601
Phone: (805) 671-9697
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 48566 | California |
Profile Details
| NPI number | 1437113479 |
|---|---|
| LBN Legal business name | Wallace, Matt |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 14th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 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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