DR. MARK WALLACE, DDS
Dentist - General Practice
Active
Individual
NPI: 1669467213
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Dentist - General Practice | 1223G0001X | Yes | 142818-9921 (UT) |
Frequently Asked Questions
NPI 1669467213 is the National Provider Identifier for DR. MARK WALLACE, DDS, a Dentist - General Practice provider located in Salt Lake City, UT. This NPI was enumerated on September 20, 2005.
DR. MARK WALLACE, DDS practices at 168 N 1950 W STE 202, Salt Lake City, UT 84116.
Quick Facts
- NPI
- 1669467213
- Type
- Individual
- Enumerated
- Sep 20, 2005
- Last Updated
- Apr 6, 2020
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