Wallace, Stephen S
Wallace, Stephen S is an sole proprietor health care provider with primary practice located at 140 Grandview Ave Suite 102, Waterbury CT 06708-2505. He recently has only one registered license in Dental Providers / Periodontics, which is considered as his primary health care specialty. Wallace, Stephen S can be contacted via phone (203) 753-1112.Contact Information
Primary practice address
140 Grandview Ave Suite 102
Waterbury CT 06708-2505
Phone: (203) 753-1112
Fax: (203) 573-0773
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Periodontics | 1223P0300X | 4383 | Connecticut |
| Dental Providers / Periodontics | 1223P0300X | 044912-1 | New York |
| Dental Providers / Periodontics | 1223P0300X | DN11169 | Massachusetts |
Profile Details
| NPI number | 1679868822 |
|---|---|
| LBN Legal business name | Wallace, Stephen S |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 16th, 2011 |
| Last updated | Mar 29th, 2012 - about 12 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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