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NPI 1255421012

IndividualActive

Joseph Wallace, D.D.S.

NPI 1255421012 · Oral and Maxillofacial Surgery (Dentist) · Greenwich, CT

Provider details

NPI number: 1255421012
Entity type: Individual
Primary specialty: Oral and Maxillofacial Surgery (Dentist)Dental Providers
Credential: D.D.S.
Sex: Male
Sole proprietor: No
License: 040760 (NY)

Practice location

23 Maple Ave

Greenwich, CT 06830-5620

Phone: (203) 661-5858

Fax: (203) 661-1159

More CT providers

Mailing address

23 Maple Ave

Greenwich, CT 06830-5620

Registry dates

Enumerated: 2006-10-13
Last updated: 2007-07-08

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

Joseph Wallace, D.D.S. — NPI 1255421012, Greenwich, CT | NPI Central