Mark Charles Wallace, DDS, PC
Mark Charles Wallace, DDS, PC provides General Practice Dentistry in Minneapolis, Minnesota. Registered with an NPI since 2014.
- In the registry since
- 2014
What do these letters mean?
- PC — Professional corporation
- A form of business registration, not a clinical qualification.
Practice location Address checks out
3909 Silver Lake Rd NEMinneapolis, MN 55421-4352 Not confirmed with CMS for 12 years — call before visiting
Phone: (612) 789-3573
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| General Practice Dentistry (primary) | Taxonomy 1223G0001X |
|---|
Record details
| NPI number | 1184046385 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Rebecca Kipp — Office Manager · (612) 789-3573 |
| Other names | Advanced Dental Group |
| NPI enumerated | January 8, 2014 |
| Last updated in NPPES | January 8, 2014 |
| Mailing address | 3909 Silver Lake Rd Ne, Minneapolis, MN 55421-4352 |
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