IndividualActive
Douglas Wallace, D.D.S., M.S.
NPI 1376698753 · Oral & Maxillofacial Surgery (D.M.D.) · Fairfield, OH
Provider details
- NPI number
- 1376698753
- Entity type
- Individual
- Primary specialty
- Oral & Maxillofacial Surgery (D.M.D.)Allopathic & Osteopathic Physicians
- Credential
- D.D.S., M.S.
- Sex
- Male
- Sole proprietor
- No
- License
- 30-01-6806 (OH)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
5188 Winton Rd
Fairfield, OH 45014-2900
Phone: (513) 829-8080
Fax: (513) 858-4290
Approximate (ZIP-level) locationGet directions
Mailing address
5188 Winton Rd
Fairfield, OH 45014-2900
Registry dates
- Enumerated
- 2007-01-24
- Last updated
- 2008-04-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.