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

Dr. Michael James Wallace, DDS

Individual provider General Practice Dentistry · NPI 1124127279

Dr. Michael James Wallace, DDS is a General Practice Dentistry in Green Bay, Wisconsin. Practices as a sole proprietor. Licensed in Wisconsin.

Licensed in
WI
In the registry since
2006
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

1195 W Mason St
Green Bay, WI 54303-2045
Phone: (920) 498-3633
Fax: (920) 498-1099
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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 2515 (WI)

Record details

NPI number1124127279
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorYes
NPI enumeratedSeptember 22, 2006
Last updated in NPPESJuly 8, 2007
Mailing address1195 W Mason St, Green Bay, WI 54303-2045

Other providers in Green Bay