Individual provider · Type 1 NPI

Mark C. Wallace, DDS

General Practice Dentistry · St. Paul, MN

NPI number 1104047190 Active

Practice location

50 County Road B E
St. Paul, MN 55117-1927

Call (651) 488-2541 Map

Fax (651) 488-8944

Mailing address

6642 Picha Pl
Eden Prairie, MN 55346-2508

Specialties and licenses

TaxonomyCodeLicense
General Practice Dentistry 1223G0001X5919 (WA)
General Practice Dentistry Primary 1223G0001XD12888 (MN)

General Practice Dentistry: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

5 other providers at this address

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About NPI 1104047190

Mark C. Wallace, DDS's National Provider Identifier is 1104047190, issued on May 1, 2007. The primary taxonomy on file is General Practice Dentistry (1223G0001X), and the practice location is in St. Paul, MN. The record was last updated on Jun 25, 2012.