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1679585038
MICHAEL PATRICK WALLACE
SAINT LOUIS, MO
NPI
1679585038
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
122300000X Dentist
(Licence: MO 13992)
Enumeration Date
2006-08-13
Last Update Date
2007-07-08
Business Address
-- MICHAEL PATRICK WALLACE DMD
9225 MANCHESTER RD SUITE 101
SAINT LOUIS, MO 63144-2640
Phone number: 314-968-0003
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Mailing Address
-- MICHAEL PATRICK WALLACE DMD
9225 MANCHESTER RD SUITE 101
SAINT LOUIS, MO 63144-2640
Phone number: 314-968-0003
Copy
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