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Dr. Jody Paul Wallace, DDS
General Practice Dentistry in Graham, North Carolina
NPI 1740210103

Jody Paul Wallace is a General Practice Dentistry based in Graham, NC and is specialized in General Practice. Jody Paul Wallace practices in Graham, NC and has the professional credentials of DDS. The NPI Number for Jody Paul Wallace is 1740210103 and holds a License No. 7500 (North Carolina).

The current practice location address for Jody Paul Wallace is 2148 Highway 54, Graham, NC and can be reached out via phone at 336-578-3884 and via fax at 336-578-3814.

Location: 2148 Highway 54, Graham, NC, 27253
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1740210103
Provider Name
Jody Paul Wallace
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
2148 Highway 54, Graham, NC, 27253
Phone Number
336-578-3884
Fax Number
336-578-3814
Provider Enumeration Date
07/03/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
89902J1 05 NC
institution
Provider Business Practice Location Address Details
Address
2148 Highway 54
City
Graham
State
North Carolina
Zip
27253
Phone Number
336-578-3884
Fax Number
336-578-3814
person
Provider Business Mailing Address Details
Address
2148 Highway 54
City
Graham
State
North Carolina
Zip
27253
Phone Number
336-578-3884
Fax Number
336-578-3814
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
7500 (North Carolina)
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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