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Active NPI 1104047190 Individual Practitioner Male Practitioner

Dr. Mark C Wallace , DDS

Dentist - General Practice • Saint Paul, MN

Professional Overview & Biography Verified Profile Summary

Dr. Mark Wallace, DDS is a registered healthcare professional specializing in Dentist - General Practice in Saint Paul, MN. Practice services are available at 50 COUNTY ROAD B E under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

50 County Road B E

Saint Paul, MN 551171927

Telephone 6514882541
Fax 6514888944
Associated Practice Facility / Clinic
🏢 Hilltop Dental, Pa Facility NPI 1235366808

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Saint Paul, MN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 14.0 Yrs
State Avg: 33.3 Yrs
Regional Practice Density
122 Specialists

Practicing in Saint Paul, MN (2262 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License MN D12888

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Dentist - General Practice

NUCC Taxonomy Code: 1223G0001X

State License WA 5919

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Dr. April Snyder , DDS

Dentist - General Practice

NPI 1134160658

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active June 25, 2012

NPI status registered as active in NPPES database

📍
Updated Practice Location June 25, 2012

Registered at 50 COUNTY ROAD B E, SAINT PAUL, MN 551171927 (Tel: 6514882541)

📍
Updated Business Mailing Address June 25, 2012

Registered at 6642 PICHA PL, EDEN PRAIRIE, MN 553462508 (Tel: 9525009805)

👤
Provider Name / Credentials Updated June 25, 2012

Recorded as MARK WALLACE, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 25, 2012

Dentist (License #D12888 in MN)

🟢
Initial NPI Registration & Enumeration May 01, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1104047190
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 01, 2007
Last Update: June 25, 2012
Sole Proprietor: No

Mailing Address

6642 Picha Pl

Eden Prairie, MN 553462508

Phone: 9525009805

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.