Wallace, Tabitha A
Wallace, Tabitha A is an individual health care provider with primary practice located at 12921 Cantrell Road Suite 101, Little Rock AR 72223-1798. She recently has only one registered license in Dental Providers / Dental Hygienist, which is considered as her primary health care specialty. Wallace, Tabitha A can be contacted via phone (501) 664-3279.Contact Information
Primary practice address
12921 Cantrell Road Suite 101
Little Rock AR 72223-1798
Phone: (501) 664-3279
Fax: (501) 664-5392
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dental Hygienist | 124Q00000X | 2217 | Arkansas |
Profile Details
| NPI number | 1629348198 |
|---|---|
| LBN Legal business name | Wallace, Tabitha A |
| Credentials | Registered Dental Hygienist (RDH) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 30th, 2011 |
| Last updated | Dec 30th, 2011 - about 14 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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