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

Dr. Mark C Wallace, DDS

Individual provider General Practice Dentistry · NPI 1104047190

Dr. Mark C Wallace, DDS is a General Practice Dentistry in Saint Paul, Minnesota. Licensed in Minnesota and Washington. Registered with an NPI since 2007.

Licensed in
MN, WA
In the registry since
2007
Specialties on file
2
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

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Practice location Address checks out

50 County Road B E
Saint Paul, MN 55117-1927
Phone: (651) 488-2541
Fax: (651) 488-8944
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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 D12888 (MN)
General Practice Dentistry Taxonomy 1223G0001X · Licence 5919 (WA)

Record details

NPI number1104047190
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorNo
NPI enumeratedMay 1, 2007
Last updated in NPPESJune 25, 2012
Mailing address6642 Picha Pl, Eden Prairie, MN 55346-2508

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