Tanner Wallace DMD PA
Clinic/Center, Dental in Hanover, New Hampshire
1316036171- Practice location
- 73 Lyme RD, Suite 3, Hanover, NH 03755
- Phone
- 603-643-3509
- Fax
- 603-643-3597
- Last updated
- September 17, 2026
Tanner Wallace DMD PA is a healthcare organization based in Hanover, NH. Tanner Wallace DMD PA practices in Hanover, NH. The NPI Number for Tanner Wallace DMD PA is 1316036171 and holds a License No. 2292 (NH). The current practice location address for Tanner Wallace DMD PA is 73 Lyme RD, Suite 3, Hanover, NH 03755 and can be reached out via phone at 603-643-3509 and via fax at 603-643-3597.
Provider Profile Details
- NPI Number
- 1316036171
- Provider Name
- Tanner Wallace DMD PA
- Provider Entity Type
- Organization
- Address
- 73 Lyme RD, Suite 3, Hanover, NH 03755
- Phone Number
- 603-643-3509
- Fax Number
- 603-643-3597
- Primary Taxonomy
- Clinic/Center, Dental · 261QD0000X
- Organization Subpart
- No
- Authorized Official
- Dr. Tanner Wallace · President · 603-643-3509
- Provider Enumeration Date
- October 12, 2006
- Last Update Date
- September 17, 2026
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 73 Lyme RD
Suite 3
Hanover, NH 03755 - City
- Hanover
- State
- New Hampshire
- Zip
- 03755
- Phone Number
- 603-643-3509
- Fax Number
- 603-643-3597
Provider Business Mailing Address Details
- Address
- 73 Lyme RD
Suite 3
Hanover, NH 03755 - City
- Hanover
- State
- NH
- Zip
- 03755
- Phone Number
- 603-643-3509
- Fax Number
- 603-643-3597
License Information
- License Number (1)
- 2292
- License State (1)
- NH
- Taxonomy (1)
- Dentist · 122300000X
- Taxonomy (2)
- Clinic/Center, Dental · 261QD0000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Clinic/Center, Dental providers near Hanover, NH
View all Clinic/Center, Dental providers in Hanover →Frequently Asked Questions
What is the NPI number of Tanner Wallace DMD PA?
The NPI number of Tanner Wallace DMD PA is 1316036171. It was assigned on October 12, 2006 and is currently active in the NPPES registry.
What is the specialty of Tanner Wallace DMD PA?
Tanner Wallace DMD PA is registered under the primary taxonomy Clinic/Center, Dental (code 261QD0000X), licensed in NH under license number 2292.
Where does Tanner Wallace DMD PA practice?
The practice location is 73 Lyme RD, Suite 3, Hanover, NH 03755. The office can be reached at 603-643-3509 (phone) or 603-643-3597 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1316036171 directly on the NPPES registry website.