Dr. Kevin R Wallace, DMD - Chicago, IL

Dr. Kevin R Wallace, DMD

General Practice Dentistry in Chicago, Illinois

NPI 1053423285

Kevin R Wallace is a General Practice Dentistry based in Lockport, IL and is specialized in General Practice. Kevin R Wallace practices in Chicago, IL and has the professional credentials of DMD. The NPI Number for Kevin R Wallace is 1053423285 and holds a License No. 019022339 (Illinois).

The current practice location address for Kevin R Wallace is 150 E Huron St, Chicago, IL and can be reached out via phone at 312-676-9893 and via fax at 815-744-7059.

Location: 150 E Huron St, Chicago, IL, 60491-9008

NPI Number

1053423285

Provider Name

Kevin R Wallace

Credential

DMD

Provider Entity Type

Individual

Gender

Male

Address

150 E Huron St, Chicago, IL, 60491-9008

Phone Number

312-676-9893

Fax Number

815-744-7059

Provider Enumeration Date

09/01/2006

Last Update Date

03/08/2024

Identifier	Type	State	Issuer
1053431981	01	IL	GROUP TYPE II NPI
1306177241	01	IL	PRACTICE LOCATION TYPE II NPI
1205145554	01	IL	PRACTICE LOCATION TYPE II NPI
1508198474	01	IL	PRACTICE LOCATION TYPE II NPI
1760882005	01	IL	PRACTICE LOCATION TYPE II NPI
1295165439	01	IL	PRACTICE LOCATION TYPE II NPI
019-022339	01	IL	DENTAL-IL
1063649770	01	IL	GROUP TYPE II NPI

Address

150 E Huron St

City

Chicago

State

Illinois

Zip

60611

Phone Number

312-676-9893

Fax Number

815-744-7059

Address

150 E Huron St

City

Chicago

State

Illinois

Zip

60611

Phone Number

312-676-9893

Fax Number

815-744-7059

Type

Dental Providers

Classification

Dentist

Speciality

Taxonomy

122300000X

License No.

019-022339 (Illinois)

Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Type

Dental Providers

Classification

Dentist

Speciality

General Practice

Taxonomy

1223G0001X

License No.

019022339 (Illinois)

Definition

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.

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