Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Gina Wallace

Individual provider Dental Hygienist · NPI 1417699505

Gina Wallace is a Dental Hygienist in Brunswick, Georgia. Practices as a sole proprietor. Licensed in Georgia.

Licensed in
GA
In the registry since
2022

Practice location Address checks out

4741 Altama Ave
Brunswick, GA 31520-2910
Phone: (912) 262-1081
Show map & directions

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

Specialties & licences

Dental Hygienist (primary) Taxonomy 124Q00000X · Licence DH043989 (GA)

Record details

NPI number1417699505
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedApril 10, 2022
Last updated in NPPESApril 10, 2022
Certification dateApril 10, 2022
Mailing address4741 Altama Ave, Brunswick, GA 31520-2910