Wallace, Stephen Landrum

Wallace, Stephen Landrum is an individual health care provider with primary practice located at 230 E 10Th St Suite 106, Anniston AL 36207-5784. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Wallace, Stephen Landrum can be contacted via phone (256) 741-7340.

Contact Information

Primary practice address
230 E 10Th St Suite 106 Anniston AL 36207-5784
Phone: (256) 741-7340
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 3219 Alabama

Profile Details

NPI number 1447381132
LBN Legal business name Wallace, Stephen Landrum
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 7th, 2007
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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Identifiers

StateTypeNumberIssuer
All States NPI 1447381132 NPPES
Alabama Other 515-34505 BLUE CROSS BLUE SHIELD
Alabama Other 515-34506 BLUE CROSS BLUE SHIELD

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