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

Michael P. Wallace DMD, PC

Organization General Practice Dentistry · NPI 1275770513

Michael P. Wallace DMD, PC is a General Practice Dentistry in Saint Louis, Missouri. Licensed in Missouri. Registered with an NPI since 2009.

Licensed in
MO
In the registry since
2009
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

9225 Manchester Rd Ste 101
Saint Louis, MO 63144-2640
Phone: (314) 968-0003
Fax: (314) 968-0383
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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 13992 (MO)

Record details

NPI number1275770513
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michael Wallace — Owner · (314) 968-0003
NPI enumeratedJanuary 8, 2009
Last updated in NPPESJanuary 8, 2009
Mailing address9225 Manchester Rd, Suite 101, Saint Louis, MO 63144-2640

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