NPI Profile for Dr KEVIN R WALLACE in CHICAGO, IL.
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
General Practice |
1223G0001X | |||
Dentist |
122300000X |
| NPI Number | 1053423285 |
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| Status | Active | |
| Credentials | DMD (Doctor of Medical Dentistry) | |
| Entity | Individual | |
| Enumeration date | 09/01/2006 | |
| Last updated | 01/19/2021 - About 5 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
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| Hospital affiliation(s) |
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KEVIN R WALLACE
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| SMILES BY DESIGN PC 203 N LA SALLIE ST CHICAGO, IL |
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