Dr. Marshall Lynn Wallace
Periodontist
3 Professional Ct
Sumter
, South Carolina 29150-1927
Dr. Marshall Lynn Wallace
Periodontist
3 Professional Ct
Sumter
, South Carolina 29150-1927
(803) 469-9023
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About
Features
Specialties
- Periodontist
Languages spoken
- English
Location
First Address
- Dr. Marshall Lynn Wallace
- 3 Professional Ct
- Sumter, SC
- Zip : 29150-1927
- Fax : (803) 469-9023
- Phone : (803) 469-9461
Second Address
- Dr. Marshall Lynn Wallace
- 3 Professional Ct
- Sumter, SC
- Zip : 29150-1927
- Fax : (803) 469-9023
- Phone : (803) 469-9461
Reviews
FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223P0300X | Periodontist | 2839/363 | SC |
National Provider Identifier
| NPI | 1124092697 |
|---|---|
| Provider Name | Dr. Marshall Lynn Wallace |
| First Address | Sumter, SC 29150-1927 |
| Second Address | Sumter, SC 29150-1927 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 14/02/2006 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| ZA9760 | (05) | SC |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.