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Contact Information

GRASS VALLEY DENTISTRY
LBN JAMES C. WALLACE DDS
122 BANK ST
GRASS VALLEY, CA95945-6520
 Phone: 530-273-4814
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Preferred Provider Organization

305R00000X
Indicates primary specialty

NPI Profile & details for GRASS VALLEY DENTISTRY

NPI Number 1366808362
LBN Legal business name JAMES C. WALLACE DDS
DBA Doing business as GRASS VALLEY DENTISTRY
Authorized official JAMES WALLACE - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 01/06/2016
Last updated 01/06/2016 - About 4 years ago
Identifiers
CA License # 32514
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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