| Caroline Wallace Dds | |
|
103 South Colorado Street Salem VA 24153 | |
| (540) 387-3844 | |
| (540) 387-3845 |
| Full Name | Caroline Wallace Dds |
|---|---|
| Speciality | Dentist |
| Location | 103 South Colorado Street, Salem, Virginia |
| Authorized Official Name and Position | Caroline Wallace (OWNER-PRESIDENT) |
| Authorized Official Contact | 3403873844 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Caroline Wallace Dds 103 South Colorado Street Salem VA 24153 Ph: (540) 387-3844 | Caroline Wallace Dds 103 South Colorado Street Salem VA 24153 Ph: (540) 387-3844 |
| NPI Number | 1295819738 |
|---|---|
| Provider Enumeration Date | 10/24/2006 |
| Last Update Date | 03/11/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295819738 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 0401007934 (Virginia) | Primary |
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