DR. Jeffrey Robert Wallace, D.D.S is a student in an organized health care education training program in Atlanta, GA. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. DR. Jeffrey Robert Wallace, D.D.S NPI is 1306006796. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a male.
The provider's business location address is:
1365 CLIFTON RD NE
BUILDING B SUITE 2300
ATLANTA, GA
ZIP 30322-013
Phone: (404) 778-4500
The enumeration date for this NPI number is 6/10/2008 and was last updated on 6/10/2008.