Dedra Danyale Wallace
Dedra Danyale Wallace is a Surgical Assistant in Laurel, Mississippi. Practices as a sole proprietor. Licensed in Mississippi.
- Licensed in
- MS
- In the registry since
- 2026
Practice location Address checks out
1220 Jefferson StLaurel, MS 39440-4355
Phone: (601) 426-4000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Surgical Assistant (primary) | Taxonomy 246ZC0007X · Licence 100297090 (MS) |
|---|
Record details
| NPI number | 1477484632 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | Yes |
| NPI enumerated | May 27, 2026 |
| Last updated in NPPES | May 27, 2026 |
| Certification date | May 27, 2026 |
| Mailing address | 3640 Old Bay Springs Rd, Laurel, MS 39440-1461 |
Other providers in Laurel
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Jansci Smith
1220 Jefferson St, Laurel, MS 39440-4355 · (601) 426-4000