Wallace, R Jeffrey

Wallace, R Jeffrey is an individual health care provider with primary practice located at 11135 Chapman Hwy , Seymour TN 37865-4857. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Wallace, R Jeffrey can be contacted via phone (865) 577-1963.

Contact Information

Primary practice address
11135 Chapman Hwy Seymour TN 37865-4857
Phone: (865) 577-1963
Fax: (865) 577-1014
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X D54694 Tennessee

Profile Details

NPI number 1285744151
LBN Legal business name Wallace, R Jeffrey
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2006
Last updated Oct 10th, 2016 - about 9 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 1285744151 NPPES
Tennessee Other 0063801 BCBS

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