Dr. Patrick L Wallace
D.D.S. | Oral and Maxillofacial Surgeon
1119 Walnut Dr, Suite 2, Ardmore
Oklahoma, 73401-2360
580-226-1727 580-226-9413
Maps & DirectionsDr. Patrick L Wallace is a Ardmore, Oklahoma based Oral and Maxillofacial Surgeon who is specialized in
Oral and Maxillofacial Surgery. He does not accept the Medicare-approved amount. Patients will be billed for the treatment. Active license number of Dr. Patrick L Wallace is
4988 for Oral and Maxillofacial Surgery in Oklahoma. His current practice location is
1119 Walnut Dr, Suite 2, Ardmore. Patients can reach him at
580-226-1727.
Dr. Patrick L Wallace deals with the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
Complete Profile:
Dr. Patrick L Wallace speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
| Name: | Dr. Patrick L Wallace |
| Specialization: | Oral and Maxillofacial Surgeon |
| Gender: | Male |
| Credentials: | D.D.S. |
| Accepts Medicare Assignment: | No |
| Practice Address: | 1119 Walnut Dr, Suite 2, Ardmore,
Oklahoma, 73401-2360 |
| Phone: | 580-226-1727 |
| Fax: | 580-226-9413 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| NPI Number: | 1508857053 |
| NPI Enumeration Date: | 03 Nov, 2005 |
| NPI Last Update On: | 13 Jan, 2014 |
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dr. Patrick L Wallace are as mentioned below.
| License Number | Specialization | State | Status | |
| 4988 | Oral and Maxillofacial Surgery | Oklahoma | Primary | |
Other Medical Identifiers:
Other legacy medical identifiers associated with Dr. Patrick L Wallace such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 100119640A | Medicaid | Oklahoma | |
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Po Box 108816,
Oklahoma City, Oklahoma |
| Zip: | 73101-8816 |
| Phone Number: | 405-848-7974 |
| Fax Number: | 405-848-0033 |
Patients can reach Dr. Patrick L Wallace at
1119 Walnut Dr, Suite 2, Ardmore, Oklahoma or can
call to book an appointment on 580-226-1727.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.