MICHAEL PATRICK WALLACE

SAINT LOUIS, MO
NPI1679585038
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy122300000X Dentist
(Licence: MO  13992)
Enumeration Date2006-08-13
Last Update Date2007-07-08
Business Address
-- MICHAEL PATRICK WALLACE DMD
9225 MANCHESTER RD SUITE 101
SAINT LOUIS, MO 63144-2640
Phone number: 314-968-0003
Mailing Address
-- MICHAEL PATRICK WALLACE DMD
9225 MANCHESTER RD SUITE 101
SAINT LOUIS, MO 63144-2640
Phone number: 314-968-0003