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

C M Wallace DDS PA

Organization General Practice Dentistry · NPI 1578612925

C M Wallace DDS PA is a General Practice Dentistry in Bonita Springs, Florida. Licensed in Florida. Registered with an NPI since 2007.

Licensed in
FL
In the registry since
2007
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

8951 Bonita Beach Rd
Bonita Springs, FL 34135-4201
Phone: (239) 992-8555
Fax: (239) 992-8644
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence DN14024 (FL)

Record details

NPI number1578612925
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Charles Wallace — Owner President · (239) 643-4746
NPI enumeratedJanuary 8, 2007
Last updated in NPPESSeptember 29, 2010
Mailing address8951 Bonita Beach Rd, Bonita Springs, FL 34135-4201

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