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

Individual provider Dentist · NPI 1679585038

Michael Patrick Wallace, DMD is a Dentist in Saint Louis, Missouri. Practices as a sole proprietor. Licensed in Missouri.

Licensed in
MO
In the registry since
2006
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.

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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

Dentist (primary) Taxonomy 122300000X · Licence 13992 (MO)

Record details

NPI number1679585038
Entity typeIndividual (Type 1)
GenderMale
Credentials DMD
Sole proprietorYes
NPI enumeratedAugust 13, 2006
Last updated in NPPESJuly 8, 2007

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