Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Tanner Wallace DMD PA

Organization Dentist · NPI 1316036171

Tanner Wallace DMD PA provides Dentist services in Hanover, New Hampshire. Licensed in New Hampshire. Registered with an NPI since 2006.

Licensed in
NH
In the registry since
2006
Specialties on file
2
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

73 Lyme Rd Ste 3
Hanover, NH 03755
Phone: (603) 643-3509
Fax: (603) 643-3597
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dental Clinic/Center (primary) Taxonomy 261QD0000X
Dentist Taxonomy 122300000X · Licence 2292 (NH)

Record details

NPI number1316036171
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Tanner Wallace — President · (603) 643-3509
NPI enumeratedOctober 12, 2006
Last updated in NPPESSeptember 17, 2026
Mailing address73 Lyme Rd, Suite 3, Hanover, NH 03755

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