Mark C Wallace in Eden Prairie - General Practice
Mark C Wallace - NPI 1104047190
Mark C Wallace is a General Practice in Eden Prairie, Minnesota. Mark C Wallace practices all healthcare services and medical treatments related to General Practice. The NPI Number for Mark C Wallace is 1104047190. The last update date is 2012-06-25.
Mark C Wallace's current location address is 6642 Picha Pl, Eden Prairie, Minnesota. You can contact this provider via phone number 9525009805. The mailing address for Mark C Wallace is 6642 Picha Pl, Eden Prairie, Minnesota. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mark C Wallace |
|---|---|
| Address | 6642 Picha Pl, Eden Prairie, Minnesota |
| Phone Number | 9525009805 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | DDS |
NPI Number Detail
| NPI Number | 1104047190 |
|---|---|
| Provider Enumeration Date | 2007-05-01 |
| Last Updated Date | 2012-06-25 |
Provider Mailing Address Detail
| Address | 6642 Picha Pl |
|---|---|
| City | Eden Prairie |
| State | Minnesota (MN) |
| Post Code | 553462508 |
| Phone Number | 9525009805 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | General Practice |
|---|---|
| Taxonomy | 1223G0001X |
| Licence No | 5919 |
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Definition: 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. |
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What is the unique identification code assigned to Mark C Wallace by the Centers for Medicare & Medicaid Services?
The Mark C Wallace has been issued the NPI (National Provider Identifier) 1104047190. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Where is the Mark C Wallace located?
The Mark C Wallace is located at 6642 Picha Pl, Eden Prairie, MN 553462508.
What is Mark C Wallace's area of expertise and its corresponding taxonomy classification?
The Mark C Wallace's field of specialization is General Practice, and it falls under the taxonomy code 1223G0001X, which categorizes healthcare providers based on their areas of practice.
On what date was the 1104047190 assigned to Mark C Wallace?
The Mark C Wallace was issued its 1104047190 on 2007-05-01, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
When was the information regarding Mark C Wallace, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Mark C Wallace, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2012-06-25.
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