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Leslie Suzanne Wallace, DMD
Pediatric Dentist in Lebanon, Tennessee
NPI 1629301833

Leslie Suzanne Wallace is a Pediatric Dentist based in Hendersonville, TN and is specialized in Pediatric Dentistry. Leslie Suzanne Wallace practices in Lebanon, TN and has the professional credentials of DMD. The NPI Number for Leslie Suzanne Wallace is 1629301833 and holds a License No. 8973 (Tennessee).

The current practice location address for Leslie Suzanne Wallace is 103 Physicians Way, Lebanon, TN and can be reached out via phone at 859-948-0386. You can also correspond with Leslie Suzanne Wallace through the mailing address at 179 COBBLER CIR, HENDERSONVILLE, TN - 37075-3963 (mailing address contact number: 859-948-0386).

Location: 103 Physicians Way, Lebanon, TN, 37075-3963
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1629301833
Provider Name
Leslie Suzanne Wallace
Credential
DMD
Provider Entity Type
Individual
Gender
Female
Address
103 Physicians Way, Lebanon, TN, 37075-3963
Phone Number
859-948-0386
Fax Number
Provider Enumeration Date
09/08/2009
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
103 Physicians Way
City
Lebanon
State
Tennessee
Zip
37090-4104
Phone Number
859-948-0386
Fax Number
person
Provider Business Mailing Address Details
Address
179 Cobbler Cir
City
Hendersonville
State
Tennessee
Zip
37075-3963
Phone Number
859-948-0386
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
8973 (Tennessee)
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
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