Organization · Type 2 NPI

Michael P. Wallace D.m.d., PC

General Practice Dentistry · St. Louis, MO

NPI number 1275770513 Active

Practice location

9225 Manchester Rd, Suite 101
St. Louis, MO 63144-2640

Call (314) 968-0003 Map

Fax (314) 968-0383

Specialties and licenses

TaxonomyCodeLicense
General Practice Dentistry Primary 1223G0001X13992 (MO)

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.

3 other providers at this address

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About NPI 1275770513

Michael P. Wallace D.m.d., PC's National Provider Identifier is 1275770513, issued on Jan 8, 2009. The primary taxonomy on file is General Practice Dentistry (1223G0001X), and the practice location is in St. Louis, MO. The record was last updated on Jan 8, 2009.